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Abuse/Neglect Recognition and Awareness In Children Presented by Lauren Jobe Abuse/Neglect Recognition and Awareness In Children Presented by Lauren Jobe

Child Abuse There are four major types of child maltreatment: neglect, physical abuse, sexual Child Abuse There are four major types of child maltreatment: neglect, physical abuse, sexual abuse and emotional abuse. Although any of the forms may be found separately, they often occur together. Ø NEGLECT: Failure to provide for a child’s basic needs. Neglect may be: ü Physical – Lack of appropriate supervision or failure to provide necessary food, shelter, or medical care. ü Educational – Failure to educate a child or attend to special education needs. ü Emotional – Inattention to child’s emotional needs or exposure to domestic violence.

Child Abuse Ø PHYSICAL ABUSE: A physical injury (ranging from minor bruises to severe Child Abuse Ø PHYSICAL ABUSE: A physical injury (ranging from minor bruises to severe fractures or death) as result of punching, beating, kicking, biting, shaking, throwing, stabbing, choking, hitting (with a hand, stick, strap, or other object), burning, or otherwise harming a child. Such injury is considered abuse regardless of whether the caretaker intended to hurt the child. Ø SEXUAL ABUSE: Activities by a parent or caretaker such as fondling a child’s genitals, penetration, incest, rape, sodomy, indecent exposure, and commercial exploitation through prostitution or the production of pornographic materials. Ø EMOTIONAL ABUSE: Any pattern of behavior that impairs a child’s emotional development or sense of self-worth. This may include constant criticism, threats, or rejection, as well as withholding love, support, or guidance. US Department of Health and Human Services National Clearinghouse on Child Abuse and Neglect Information Prevent Child Abuse America

Abuse Among Children with Disabilities Some researchers suggest that children with disabilities may have Abuse Among Children with Disabilities Some researchers suggest that children with disabilities may have increased vulnerability to abuse. Children with disabilities may be perceived as less valuable than other children. Other factors leading to abuse among children with disabilities are the same as those found in the general population: single parents, teen parents, various levels of stress. Families with children with disabilities can experience additional stressors including: ü Feeling unprepared to handle the care of a disabled child, including acceptance of that child as being “different”. ü Having financial or time limits stretched as additional medical/educational activities are suggested. ü Lacking necessary social supports or networks to work through the many concerns and situations that arise in providing care for the child and the rest of the family. Prevent Child Abuse America

Recognizing the Warning Signs Warning signs of physical abuse: ü Excessively withdrawn, fearful or Recognizing the Warning Signs Warning signs of physical abuse: ü Excessively withdrawn, fearful or anxious about doing something wrong ü Shows extremes in behavior (extremely compliant or extremely demanding; extremely passive or extremely aggressive. ü Doesn’t seem to be attached to the parent or care giver. ü Acts either inappropriately adult (taking care of other children) or inappropriately infantile (rocking, thumb-sucking, throwing tantrums). Warning signs of Neglect: ü Clothes are ill-fitting, filthy, or inappropriate for the weather. ü Hygiene is consistently bad (unbathed, matted and unwashed hair, noticeable body odor). ü Untreated illnesses and physical injuries. ü Is frequently unsupervised or left alone or allowed to play in unsafe situations and environments. ü Is frequently late or missing from school. Help. Guide. Org

Recognizing the Warning Signs Cont. Warning Signs of physical abuse: ü Frequent injuries or Recognizing the Warning Signs Cont. Warning Signs of physical abuse: ü Frequent injuries or unexplained bruises, welts, or cuts ü Is always watchful and “on alert, ” as if waiting for something bad to happen. ü Injuries appear to have a pattern such as marks from a hand or belt. ü Shies away from touch, flinches at sudden movements, or seems afraid to go home. ü Wears inappropriate clothing to cover up injuries, such as long-sleeved shirts on hot days. Warning Signs of sexual abuse: ü Trouble walking or sitting. ü Displays knowledge or interest in sexual acts inappropriate to his or her age, or Even seductive behavior. ü Makes strong efforts to avoid specific person, without an obvious reason. ü Doesn’t want to change clothes in front of others or participate in physical activities. ü Runs away from home. Help. Guide. Org

Mandatory Reporting Ø Individuals designated as mandatory reporters typically have frequent contact with children. Mandatory Reporting Ø Individuals designated as mandatory reporters typically have frequent contact with children. Typically, a report must be made when a reporter, in his or her official capacity, suspects or has reasons to believe that a child has been abused or neglected. Another standard frequently used is in situations in which the reporter has knowledge of, or observes a child being subjected to, conditions that would reasonably result in harm to the child. Mandatory reporting statutes also may specify when a communication is privileged. “Privileged communications” is the statutory recognition of the right to maintain confidential communications between professionals and their clients, patients, or congregants (Taken from the Child Welfare Information Gateway. http: //www. childwelfare. gov August 2012). Ø Mandated Reporter’s § … Shall immediately upon receiving such information (suspected or known abuse/neglect) report or cause a report to be made of such fact to the county department OR local law enforcement agency (19 -3 -304)

Who are Mandated Reporters? 19 -3 -304. Persons required to report child abuse or Who are Mandated Reporters? 19 -3 -304. Persons required to report child abuse or neglect. (2) Persons required to report such abuse or neglect or circumstances or conditions include any: (a) Physician or surgeon, including a physician in training; (b) Child health associate; (c) Medical examiner or coroner; (d) Dentist; (e) Osteopath; (f) Optometrist; (g) Chiropractor; (h) Podiatrist; (i) Registered nurse or licensed practical nurse; (j) Hospital personnel engaged in the admission, care, or treatment of patients; (k) Christian science practitioner; (l) Public or private school official or employee; (m) Social worker or worker in any facility or agency that is licensed or certified pursuant to part 1 of article 6 of title 26, C. R. S. ; (n) Mental health professional; (o) Dental hygienist; (p) Psychologist; (q) Physical therapist; (r) Veterinarian; (s) Peace officer as described in section 16 -2. 5 -101, C. R. S. ; (t) Pharmacist; (u) Commercial film and photographic print processor as provided in subsection (2. 5) of this section; (v) Firefighter as defined in section 18 -3 -201 (1), C. R. S. ; (w) Victim's advocate, as defined in section 13 -90 -107 (1) (x) Licensed professional counselors; (y) Licensed marriage and family therapists; (z) Registered psychotherapists;

Who are Mandated Reporters? Cont. (aa) (I) Clergy member. (bb) Registered dietitian who holds Who are Mandated Reporters? Cont. (aa) (I) Clergy member. (bb) Registered dietitian who holds a certificate through the commission on dietetic registration and who is otherwise prohibited by 7 CFR 246. 26 from making a report absent a state law requiring the release of this information; (cc) Worker in the state department of human services; (dd) Juvenile parole and probation officers; (ee) Child and family investigators, as described in section 14 -10 -116. 5, C. R. S. ; (ff) Officers and agents of the state bureau of animal protection, and animal control officers; (gg) The child protection ombudsman as created in article 3. 3 of this title; (hh) Educator providing services through a federal special supplemental nutrition program for women, infants, and children, as provided for in 42 U. S. C. sec. 1786; (ii) Director, coach, assistant coach, or athletic program personnel employed by a private sports organization or program. For purposes of this paragraph (ii), "employed" means that an individual is compensated beyond reimbursement for his or her expenses related to the private sports organization or program. (jj) Person who is registered as a psychologist candidate pursuant to section 12 -43 -304 (7), C. R. S. , marriage and family therapist candidate pursuant to section 12 -43 -504 (5), C. R. S. , or licensed professional counselor candidate pursuant to section 12 -43 -603 (5), C. R. S. , or who is described in section 12 -43 -215, C. R. S. ; and (kk) Emergency medical service providers, as defined in sections 25 -3. 5 -103 (8) and 25 -3. 5 -103 (12), C. R. S. , and certified pursuant to part 2 of article 3. 5 of title 25, C. R. S.

Failure to Report Ramifications Ø If by employment or other reason you meet the Failure to Report Ramifications Ø If by employment or other reason you meet the definition (as listed) of who is required to make a report; q You are subject to criminal and civil penalties for WILLFULLY failing to report suspected or known child abuse to law enforcement or CPS agency (a, b) q If you WILLFULLY make a FALSE report of child abuse you are subject to criminal and civil penalties (a, b) • (a) class 3 misdemeanor and shall be punished as provided in section 18 -1. 3 -501, C. R. S. ; • (b) Shall be liable for damages proximately caused thereby.

Failure to Report Ramifications Cont. Ø If Rocky Mountain Human Services (RMHS) becomes aware Failure to Report Ramifications Cont. Ø If Rocky Mountain Human Services (RMHS) becomes aware of an allegation of abuse/neglect involving a child in our program and it is discovered that one of our contracted providers has knowledge of, but fails to make a report, that provider may be subject to a full investigation and the following may occur: 1. At a minimum, a hold may be placed on any new referrals to the provider. 2. Current services being provided by therapist may be suspended. The arrangement for coverage of those services to customers will be made by the Child and Family Programs Department. 3. Termination of his/her contract with RMHS

Reporting Procedures for Children- Providers Ø As a mandated reporter, if you become aware Reporting Procedures for Children- Providers Ø As a mandated reporter, if you become aware of a situation where a child’s physical and or emotional well—being is at risk you are required to: 1. If a child is in imminent Danger, please contact the local police immediately at 720 -913 -2000. 2. Make a report to the Department of Human Services- Child Abuse Hotline at 720 -944 -3000. 3. Contact the service coordinator immediately to inform him/her of the situation. If the Service Coordinator is not available, please contact his/her supervisor or another member of the management team in the Child and Family Programs Department. 4. An incident report must be completed within 24 hours of the incident if MANE (Mistreatment, Abuse, Neglect, Exploitation) is suspected. The Service Coordinator can provide you with an electronic copy of the incident report. Ø Any person who makes a report cannot be identified to the family and remains anonymous.

Reporting Procedures for Children- Service Coordinators Ø As a mandated reporter, if you become Reporting Procedures for Children- Service Coordinators Ø As a mandated reporter, if you become aware of a situation where a child’s physical and or emotional well—being is at risk you are required to: 1. If a child is in imminent Danger, please contact the local police immediately at 720 -913 -2000. 2. If information was received from a provider, document conversation, discuss with provider reporting and send an IR form to the provider to complete within 24 hours. 3. Contact your Program Manager or if he/she is unavailable any program manager to discuss the situation. 4. Make a report to the Department of Human Services- Child Abuse Hotline at 720 -944 -3000. 5. If directly observed you must complete an incident report within 24 hours of the incident if MANE (Mistreatment, Abuse, Neglect, Exploitation) is suspected. You can complete the incident report in Dynamo. Ø Any person who makes a report cannot be identified to the family and remains anonymous.

Critical Incidents other than MANE (FSSP Children Only) Critical Incidents are situations that require Critical Incidents other than MANE (FSSP Children Only) Critical Incidents are situations that require an Incident Report to be completed by provider/SC within 3 business days if MANE (Mistreatment, Abuse, Neglect, Exploitation) is not suspected. Critical incidents include: Ø Serious injuries or other medical crises or occurrences requiring immediate emergency medical treatment to preserve life and limb or resulting in an emergency admission to the hospital. q Generally serious injuries or medical emergencies would include, but not be limited to: • Fractures of a major bone (Example: hip, femur, humerus, shoulder, ribs); • Dislocations of a major joint (Example: hip, knee, shoulder, elbow, ankle or wrist); • Head injuries with loss of consciousness; • Lacerations; • Third degree burns ; • Prolonged seizures; • Bowel obstructions; • Diabetic crises; • Pneumonia; • Medication emergency (Example: overdose, toxicity, etc. ) • Emergency admittance into psychiatric facility necessary to protect the person receiving services or others.

Critical Incidents other than MANE Cont. Ø Incidents when a person was a victim Critical Incidents other than MANE Cont. Ø Incidents when a person was a victim of a serious crime Ø Serious criminal offense by person receiving services Ø Likely media interest or involvement in a situation Ø Behavioral incidents which: • Cause property damage; • Injury to individual, other customer/s and or staff member/s Ø Emergency or Safety control procedure used Ø Lost or missing persons Ø Stolen property Ø Unusual behavior Ø Death (For all Children Associated with RMHS)

Completing an RMHS Incident Report DO üWrite in ink (preferably black) üBe descriptive, not Completing an RMHS Incident Report DO üWrite in ink (preferably black) üBe descriptive, not evaluative üWrite out the complete date (month, day and year) üWrite the time you are documenting and include the time of the incident üWrite legibly or print üDraw one line through errors; above it write "error", your initials and the date üSign your full name (first initial and last name) and your title if applicable üUse only approved abbreviations or write out the words üWrite in chronological order üDraw a line through any unused space between the end of the comment and your signature so that what you write cannot be altered üIdentify each document with the persons full name in the following order: last, first and middle initial DON’T ODon't erase, use white out or blot out any error ODon't use nicknames for persons receiving services ODon't falsify any documentation

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