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Child Abuse Identification and Reporting: The New York Requirement

Course #97533 - $15 • 2 Hours/Credits

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  • Participation Instructions
    • Review the course material online or in print.
    • Complete the course evaluation.
    • Review your Transcript to view and print your Certificate of Completion. Your date of completion will be the date (Pacific Time) the course was electronically submitted for credit, with no exceptions. Partial credit is not available.
  1. The first child abuse case in the United States that garnered widespread interest involved Mary Ellen Wilson, a foster child in New York City. This case took place in

    HISTORICAL CONTEXT

    The first public case of child abuse in the United States that garnered widespread interest took place in 1866 in New York City. Mary Ellen Wilson was an illegitimate child, 10 years of age, who lived with her foster parents [3]. Neighbors were concerned that she was being mistreated; however, her foster parents refused to change their behaviors and said that they could treat the child as they wished [2]. Because there were no agencies established to protect children specifically, Henry Berge, founder of the Society for the Prevention of Cruelty to Animals, intervened on Mary's behalf [3]. He argued that she was a member of the animal kingdom and deserved protection. The case received much publicity, and as a result, in 1874 the New York Society for the Prevention of Cruelty to Children was formed [3]. Because of this case, every state now has a child protective services (CPS) system in place.

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  2. Child abuse is defined at the federal level by the

    DEFINITIONS OF CHILD ABUSE AND NEGLECT

    The federal definition of child abuse is evident in CAPTA, published as a product of federal legislation. CAPTA defines a child to be any individual younger than 18 years of age, except in cases of sexual abuse. In cases of sexual abuse, the age specified by the child protection laws varies depending on the state in which the child resides [5]. CAPTA defines child abuse as, "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" [6]. The state of New York defines child abuse and neglect as follows [7]:

    The term abuse encompasses the most serious harms committed against children. An "abused child" is a child whose parent or other person legally responsible for his/her care inflicts upon the child serious physical injury, creates a substantial risk of serious physical injury, or commits a sex offense against the child. Not only can a person be abusive to a child if they perpetrate any of these actions against a child in their case, they can be guilty of abusing a child if they allow someone else to do these things to that child.

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  3. Which of the following injuries is NOT considered a possible indicator of physical abuse?

    DEFINITIONS OF CHILD ABUSE AND NEGLECT

    Bruises and welts are of concern, particularly those that appear on:

    • The face, lips, mouth, ears, eyes, neck, or head

    • The trunk, back, buttocks, thighs, or extremities

    • Multiple body surfaces

    Patterns such as the shape of the article (e.g., a cord, belt buckle, teeth, hand) used to inflict the bruise or welt should be noted. Cigar or cigarette burns are common, and they will often appear on the child's soles, palms, back, or buttocks. Patterned burns that resemble shapes of appliances, such as irons, burners, or grills, are of particular concern.

    Fractures that result from abuse might be found on the child's skull, ribs, nose, or any facial structure. These may be multiple or spiral fractures at various stages of healing. When examining patients, note bruises on the abdominal wall, any intestinal perforation, ruptured liver or spleen, and blood vessel, kidney, bladder, or pancreatic injury, especially if accounts for the cause do not make sense. Look for signs of abrasions on the child's wrists, ankles, neck, or torso. Lacerations might also appear on the child's lips, ears, eyes, mouth, or genitalia. If violent shaking or trauma occurred, the child might experience a subdural hematoma [8,61].

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  4. Child sexual abuse is categorized as exhibitionism if the act involves

    DEFINITIONS OF CHILD ABUSE AND NEGLECT

    Child sexual abuse can be committed by a stranger or an individual known to the child. Sexual abuse may be manifested in many different ways, including [9,10]:

    • Verbal: Obscene phone calls or talking about sexual acts for the purpose of sexually arousing the adult perpetrator

    • Voyeurism: Watching a child get dressed or encouraging the child to masturbate while the perpetrator watches

    • Commercial sexual exploitation and child sex trafficking: Involving the child in sexual acts for monetary profit

    • Child pornography: Taking photos of a child in sexually explicit poses or acts

    • Exhibitionism: Exposing his/her genitals to the child or forcing the child to observe the adult or other children in sexual acts

    • Molestation: Touching, fondling, or kissing the child in a provocative manner; for example, fondling the child's genital area or long, lingering kisses

    • Sexual penetration: The penetration of part of the perpetrator's body (e.g., finger, penis, tongue) into the child's body (e.g., mouth, vagina, anus)

    • Rape: Usually involves sexual intercourse without the victim's consent and usually involves violence or the threat of violence

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  5. A child discloses that he has not gone to school for two weeks. When questioned regarding the reason for the absences, the child states that his parents do not feel like bringing him to school. This may be reported as which type of abuse?

    DEFINITIONS OF CHILD ABUSE AND NEGLECT

    The following behaviors constitute emotional abuse and neglect [6,11,12]:

    • Verbal abuse: Belittling or making pejorative statements in front of the child, which results in a loss or negative impact on the child's self-esteem or self-worth

    • Inadequate nurturance/affection: Inattention to the child's needs for affection and emotional support

    • Witnessing domestic violence: Chronic spousal abuse in homes where the child witnesses the violence

    • Substance and/or alcohol abuse: The parent/caretaker is aware of the child's substance misuse problem but chooses not to intervene or allows the behavior to continue

    • Refusal or delay of psychologic care: Failure or delay in obtaining services for the child's emotional, mental, or behavioral impairments

    • Permitted chronic truancy: The child averages at least five days per month of school absence and the parent/guardian does not intervene

    • Failure to enroll: Failure to enroll or register a child of mandatory school age or causing the child to remain at home for nonlegitimate reasons

    • Failure to access special education services: Refusal or failure to obtain recommended services or treatment for remedial or special education for a child's diagnosed learning disorder

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  6. The majority of child abuse reports are made by

    EPIDEMIOLOGY OF CHILD ABUSE AND NEGLECT

    In 2018, there were 4.3 million referrals to CPS agencies in the United States [15]. Almost 2.4 million were assessed to be appropriate for a response, and the majority (67.4%) of reports were made by health and mental health professionals [15]. Girls tend to be victims at a slightly higher rate (9.6 per 1,000 girls) compared with boys (8.7 per 1,000 boys) [15]. More than a half (53.8%) of perpetrators are women, and the majority (83.3%) are between the ages of 18 and 44 years [15].

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  7. In 2018, how many children in New York died as a result of child abuse and neglect?

    EPIDEMIOLOGY OF CHILD ABUSE AND NEGLECT

    In 2018, the rate of child abuse and neglect in New York State was 16.9 per 1,000 children [15]. This translates to approximately 68,785 cases of child abuse and neglect in New York in 2018, an increase of 5.8% compared with 2014 [15]. In terms of fatalities, 118 children in New York died in 2018 as a result of child abuse and neglect—a rate of 2.9 per 100,000 children [15]. This is greater than the national rate of 2.39 per 100,000 per children [15].

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  8. Which of the following is a parental risk indicator that may be present in cases of child abuse/neglect?

    RECOGNIZING WARNING SIGNS

    It is crucial that practitioners become familiar with the indications of child abuse and neglect. These factors do not necessarily conclusively indicate the presence of abuse or neglect; rather, they are clues that require further interpretation and clinical investigation. Some parental risk indicators include [8; 10; 12; 15; 16; 64]:

    • Recounting of events that do not conform either with the physical findings or the child's physical and/or developmental capabilities

    • Inappropriate delay in bringing the child to a health facility

    • Unwillingness to provide information or the information provided is vague

    • History of family violence in the home

    • Parental misuse of substances and/or alcohol

    • Minimal knowledge or concern about the child's development and care

    • Environmental stressors, such as poverty, single parenthood, unemployment, or chronic illness in the family

    • Unwanted pregnancy

    • Early adolescent parent

    • Expression that the parent(s) wanted a baby in order to feel loved

    • Unrealistic expectations of the child

    • Use of excessive physical punishment

    • Healthcare service "shopping"

    • History of parent "losing control" or "hitting too hard"

    • Asks teacher to employ harsh disciplining for misbehaviors

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  9. Of the following, who is legally mandated by the state of New York to report suspected cases of child abuse?

    REPORTING SUSPECTED CHILD ABUSE

    The following individuals are classified as mandated reporters in the state of New York [26]:

    • Physicians (including osteopaths)

    • Registered physician's assistants

    • Surgeons

    • Medical examiners

    • Coroners

    • Dentists

    • Dental hygienists

    • Optometrists

    • Chiropractors

    • Podiatrists

    • Medical residents

    • Interns

    • Psychologists

    • Registered nurses

    • Social workers

    • Emergency medical technicians

    • Licensed creative arts therapists

    • Licensed marriage and family therapists

    • Licensed mental health counselors

    • Licensed psychoanalysts

    • Hospital personnel engaged in the admission, examination, care, or treatment of persons

    • Christian Science practitioners

    • School officials

    • Social services workers

    • Day care center workers

    • Providers of family or group family day care

    • Any employees or volunteers in a residential care facility for children

    • Any other childcare or foster care workers

    • Mental health professionals

    • Substance abuse counselors

    • Alcoholism counselors

    • Peace officers

    • Police officers

    • District attorneys or assistant district attorneys

    • Investigators employed in the Office of the District Attorney

    • Any other law enforcement officials

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  10. Patient A, a child 10 years of age, arrives at the emergency department with a burn. Upon intake, a registered nurse notices that the burn on the child's thigh resembles the face of an iron. In addition, the child has bruising on her upper arm. The nurse suspects abuse and therefore calls the toll-free number for mandated reporters to report the case. Which of the following steps must the nurse take following the report?

    REPORTING SUSPECTED CHILD ABUSE

    The SCR is open 24 hours per day, 7 days per week [26]. The mandated reporter is not obligated to contact the parents or the legal guardians of the child either before or after the call to SCR [26]. Good practice dictates that the reporter either seek consent or notify the parent(s) that essential information is being (and is required to be) shared, unless doing so would put the child's health or safety at risk. However, even if the parent does not consent, the mandated reporter is still obligated to contact the SCR [26]. (Additional child abuse hotline information may be found in the Resources section of this course.)

    The worker who answers the phone will attempt to accumulate as much information from you as possible. According to the New York State Office of Children and Family Services, they will ask you the following types of questions [26,38]:

    • What is the nature and extent of the child's injuries, or the risk of harm to the child?

    • Have there been any prior suspicious injuries to this child or his/her siblings?

    • What is the child's name, home address, age?

    • What is the name and address of the parent or other person legally responsible who caused the injury, or created the risk of harm to the child?

    • What are the names and addresses of the child's siblings and parents if different from the information provided above?

    • Do you have any information regarding treatment of the child, or the child's current whereabouts?

    Within 48 hours of reporting the suspected abuse to SCR, the reporter must also complete and sign a written report (LDSS-2221A) and submit the report to the local department of social services (LDSS) that has been assigned to the investigation [26]. The forms may be accessed on the New York State of Children and Family Services website at https://ocfs.ny.gov/search/docs.php.

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  • Back to Course Home
  • Participation Instructions
    • Review the course material online or in print.
    • Complete the course evaluation.
    • Review your Transcript to view and print your Certificate of Completion. Your date of completion will be the date (Pacific Time) the course was electronically submitted for credit, with no exceptions. Partial credit is not available.