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Child Abuse

2 Contact Hours
Not approved for Iowa, New York, or Pennsylvania requirements.
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This peer reviewed course is applicable for the following professions:
Advanced Practice Registered Nurse (APRN), Athletic Trainer (AT/AL), Certified Nurse Midwife, Certified Nurse Practitioner, Certified Nursing Assistant (CNA), Certified Registered Nurse Anesthetist (CRNA), Clinical Nurse Specialist (CNS), Home Health Aid (HHA), Licensed Nursing Assistant (LNA), Licensed Practical Nurse (LPN), Licensed Vocational Nurses (LVN), Medical Assistant (MA), Medication Nursing Assistant, Midwife (MW), Nursing Student, Occupational Therapist (OT), Occupational Therapist Assistant (OTA), Physical Therapist (PT), Physical Therapist Assistant (PTA), Registered Nurse (RN), Registered Nurse Practitioner, Respiratory Care Practitioner, Respiratory Therapist (RT)
This course will be updated or discontinued on or before Tuesday, April 2, 2024

Nationally Accredited

CEUFast, Inc. is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. ANCC Provider number #P0274.

CEUFast, Inc. is an AOTA Provider of professional development, Course approval ID#02405.This distant learning-independent format is offered at 0.2 CEUs Intermediate,Categories:Foundational Knowledge. AOTA does not endorse specific course content, products, or clinical procedures. AOTA provider number 9757.

BOC
CEUFast, Inc. (BOC AP#: P10067) is approved by the Board of Certification, Inc. to provide education to Athletic Trainers (ATs).
FPTA Approval: CE23-536793, CE24-536793. Accreditation of this course does not necessarily imply the FPTA supports the views of the presenter or the sponsors.
Outcomes

≥90% of participants will identify and respond appropriately to child abuse.

Objectives

After completing this course, the learner will be able to meet the following objectives:

  1. Define Child Abuse.
  2. Identify the physical and behavioral indicators of child abuse and maltreatment/neglect.
  3. Discuss the impact of abuse on children.
  4. Respond appropriately to reasonable cause to suspect abuse or maltreatment.
  5. Identify resources for reporting child abuse.
CEUFast Inc. and the course planners for this educational activity do not have any relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
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To earn of certificate of completion you have one of two options:
  1. Take test and pass with a score of at least 80%
  2. Reflect on practice impact by completing self-reflection, self-assessment and course evaluation.
    (NOTE: Some approval agencies and organizations require you to take a test and self reflection is NOT an option.)
Author:    Julia Tortorice (RN, MBA, MSN, NEA-BC, CPHQ)

Prevalence and Demographics

Violence is an important public health issue. The World Health Organization (WHO) estimates that nearly 53,000 children are murdered each year. The prevalence of forced sexual intercourse and other forms of sexual violence involving touch among boys and girls under 18 is 73 million and 150 million, respectively (WHO, 2020).

The U.S. Department of Health & Human Services reports that around 678,000 victims of child abuse and neglect nationally. The victim rate is 9.2 victims per 1,000 children in the population (DHHS, 2018).

Victim demographics include (DHHS, 2018).:

  • Children in their first year of life have the highest victimization rate at 26.7 per 1,000 children of the same age in the national population.
  • The victimization rate for girls is 9.6 per 1,000 girls in the population, which is higher than boys at 8.7 per 1,000 boys.
  • American Indian or Alaska Native children have the highest rate of victimization at 15.2 per 1,000 children in the population of the same race or ethnicity.
  • African American children have the second-highest rate at 14.0 per 1,000 children of the same race or ethnicity.

Child fatalities are estimated at 1,770 children who died from abuse and neglect at a rate of 2.39 per 100,000 children in the population (DHHS, 2018).

The youngest children are the most vulnerable to maltreatment, with 46.6 percent of child fatalities younger than one year old and died at a rate of 22.77 per 100,000 children in the population of the same age. Boys have a higher child fatality rate than girls, 2.87 per 100,000 boys in the population, compared with 2.19 per 100,000 girls (DHHS, 2018).

The rate of African-American child fatalities (5.48 per 100,000 African-American children) is 2.8 times greater than the rate of White children (1.94 per 100,000 White children) and 3.4 times greater than the rate of Hispanic children (1.63 per 100,000 Hispanic children) (DHHS, 2018).

Perpetrator Analysis (DHHS, 2018).:

  1. 83.3% of perpetrators are between 18 and 44 years old.
  2. 53.8% of perpetrators are female, and 45.3 percent are male.
  3. The three largest percentages of perpetrators are:
    1. White (49.6%)
    2. African-American (20.6%)
    3. Hispanic (19.3%)
  4. 77.5% of perpetrators are a parent to their victims.
  5. Caregivers who compulsively use alcohol or drugs were found to be at the highest risk to abuse a child.

Definition

Each state defines child abuse and neglect within the civil and criminal context. Civil laws, or statutes, describe the circumstances and conditions that obligate mandated reporters to report known or suspected cases of abuse. They also provide definitions necessary for juvenile/family courts to take custody of a child alleged to have been maltreated. Criminal statutes define the criminally punishable forms of maltreatment. All states require healthcare personnel, school personnel, daycare providers, and law enforcement personnel to report child abuse. Failure to do so is a crime.

Child abuse and neglect are, at a minimum:

  • 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
  • An act or failure to act that presents an imminent risk of serious harm

Indicators

Indicators of abuse warn the healthcare professional to pay more attention to a particular situation. Sometimes there are no indicators even though the child is being abused. There are three types of abuse or maltreatment/neglect

  1. physical indicators
  2. child behavioral indicators
  3. parent behavioral indicators

Indicators should not be viewed alone they must be considered in relation to the child's condition. Indicators should be considered in the overall context of the child's physical appearance and behavior. Sometimes a single indicator is self-evident or points to abuse or maltreatment/neglect. Often, several indicators must be pulled together, or clusters of indicators used to develop reasonable cause.

Some healthcare professionals see a child only once or very infrequently; others see them more often. In looking for reasonable cause, you need to consider what you know about the child's normal behavior. No two children will respond the same way to the same situation.

Physical Indicators

Common physical indicators are severe, unexplained, or suspicious bruises and welts, fractures, burns, lacerations, or abrasions. Specific physical indicators are (SUNY, 2011):

  1. Unexplained bruises and welts
    1. On face, lips, mouth, torso, back, buttocks or thighs.

Handprint Injury

Handprint Injury
(AbuseWatch.net, 2012)

Bruising of torso, buttocks and thighs

Bruising (AbuseWatch, nd)

  1. Bruising of torso, buttocks, and thighs
  2. Bruises in various stages of healing clustered bruises forming regular patterns that might reflect the shape of an article used to inflict the injury
  3. Bruises on several different areas
  4. Bruises regularly appear after absence, weekend, or vacation
  1. Unexplained fractures
    1. To nose, skull, or facial structure
    2. In various stages of healing
    3. Multiple or Spiral fractures

Spiral Fracture

Spiral Fracture(AbuseWatch, nd)

  1. Swollen or tender lambs
  1. Unexplained burns
    1. Cigar, cigarette burns especially on the soles of feet, palms, back and buttocks

Cigarette burn

Cigarette burn (AbuseWatch, nd)

  1. Immersion burns: sock-like, glove-like, doughnut-shaped on buttocks or genitalia

Glove like burn

Glove-like burn (AbuseWatch, nd)

Sock like burn

Sock-like burn (AbuseWatch, nd)

  1. Patterned like electric burner or iron

Steam Injury

Steam Iron Injury (AbuseWatch, nd)

  1. Rope burns on arms, legs, neck, or torso

Looped Cord Injury

Looped cord injury (AbuseWatch, nd)

  1. Unexplained lacerations or abrasions
    1. To mouth, lips, gums, or eyes
    2. To external genitalia
    3. On the back of arms, legs, or torso
    4. Human bite marks
    5. Frequent injuries that are accidental or unexplained

Accidental injuries usually involve injury on a bony prominence of the body such as elbows and knees and shins. Suspicious injuries usually occur in areas not susceptible to accidental age-appropriate areas. The following pictures indicate areas where children would normally bruise, and suspicious bruising areas, as well as other suspicious areas of injury.

Areas of bruising and injury that may indicate abuse (AbuseWatch, nd).

Bruising Areas

 

Suspicious bruising

Clues to the mechanism of injury (AbuseWatch, nd)

 

Machanism of injury

Consider the size and shape of the injury, as well as the location of the injury (SUNY, 2011). Consider the relationship of the mechanism of injury (explanation of how the injury occurred) to the child's developmental stage. For example, toddlers fall when they learn to walk, and young children scrape their knees when riding a bicycle. Consider if the story that was given as an explanation for an injury would produce the present physical indicators. For instance, a toddler falls to the floor while walking, not striking anything when he falls. That toddler has bruises on the back of his legs. One would expect that from a fall while walking. The toddler would have bruises and scrapes on his hands, knees, and shins, not bruises on the back of his legs.

Child behavioral indicators of physical abuse may be (SUNY, 2011).:

  1. The child is wary of adult contact
  2. Apprehensive when other children cry
  3. Demonstrates behavioral extremes
  4. Frightened of parents
  5. Afraid to go home
  6. Reports injury by a parent
  7. Wears long sleeve or similar clothing to hide injuries
  8. Seeks affection from adults

Parent behavioral indicators of physical abuse may be (SUNY, 2011).:

  1. Seemed unconcerned about the child
  2. It takes an unusual amount of time to obtain medical care for the child
  3. Offers inadequate or inappropriate explanations for the injury
  4. Gives different explanations for the same injury
  5. Misuses drugs or alcohol
  6. Disciplines the child too harshly, considering the child's age or what she has done wrong
  7. Sees the child as bad or evil
  8. Has a history of abuse as a child
  9. Attempts to conceal the child's injury
  10. Takes a child to a different hospital or doctor for each injury
  11. Has poor impulse control

Maltreatment/Neglect

Child physical indicators of maltreatment/neglect may be (SUNY, 2011).:

  1. Consistent hunger, poor hygiene, inappropriate dress
  2. Consistent lack of supervision, especially in dangerous activities or for long periods
  3. Unattended physical problems or medical or dental needs
  4. Abandonment

Child behavioral indicators of maltreatment/neglect may be (SUNY, 2011).:

  1. Begging or stealing food
  2. Extended stays in school – arrives early, leaves late
  3. Attendance at school is infrequent
  4. Consistent fatigue falls asleep in class
  5. Alcohol and drug abuse
  6. States there is no caretaker

Parental behavior indicators of maltreatment/neglect may be (SUNY, 2011).:

  1. Misuses alcohol or other drugs
  2. Has disorganized, upsetting home life
  3. Is apathetic, feeling nothing will change
  4. Is isolated from friends, relatives, neighbors
  5. Has long term chronic illness
  6. Cannot be found
  7. Has a history of neglect as a child
  8. Exposes a child to unsafe living conditions
  9. Evidence limited intellectual capacity

Emotional Maltreatment

Child physical indicators of emotional maltreatment may be (SUNY, 2011).:

  1. Conduct disorders such as fighting in school, antisocial, or destructive.
  2. Habit disorders such as rocking, fighting, or sucking fingers.
  3. Neurotic disorders such as speech disorders sleep problems, or inhibition of play.
  4. Psychoneurotic reactions such as phobias, hysterical reactions, compulsions, or hypochondria.
  5. Lags in physical development.
  6. Failure to thrive.

failure to thrive

Failure to Thrive (AbuseWatch, nd)

Child behavioral indicators of emotional maltreatment may be (SUNY, 2011):

  1. Overly adaptive behavior such as inappropriately adult or inappropriately infantile
  2. Developmental delays, mental or emotional
  3. Extremes of behavior such as compliant, passive, aggressive, or demanding
  4. Suicide attempt or gestures or self-mutilation

Parent behavioral indicators of emotional maltreatment may be (SUNY, 2011):

  1. Treats children in the family unequally
  2. Does not seem to care much about a child's problem
  3. Blames or belittles the child
  4. Is cold and rejecting
  5. Inconsistent behavior toward the child

Sexual Abuse

Child physical indicators of sexual abuse may be (SUNY, 2011).:

  1. Difficulty in walking or sitting
  2. Torn, sustained, or bloody underclothing
  3. Pain or itching in genitalia
  4. Pregnancy, especially in early adolescence
  5. Bruises or bleeding in external genitalia, vaginal or anal areas
  6. Sexually transmitted diseases, especially in the pre-adolescent age group, includes oral venereal infections

Child behavioral indicators of sexual abuse may be (DHHS, 2018).:

  1. Unwilling to change for or participate in a physical education class
  2. Withdrawal, fantasy, or infantile behavior
  3. Bizarre, sophisticated, unusual sexual behavior or knowledge
  4. Self-injurious behaviors, suicide attempts
  5. Poor peer relationships
  6. Aggressive or disruptive behavior, delinquency, running away, or school truancy
  7. Reports sexual assault by caretakers
  8. The exaggerated fear of closeness or physical contact

Parent behavioral indicators of sexual abuse may be (SUNY, 2011):

  1. Very protective or jealous of the child
  2. Encourages the child to engage in prostitution or sexual acts in the presence of a caretaker
  3. Misuses alcohol or drugs
  4. Is geographically isolated or lacking in social and emotional contacts outside the family
  5. Has low self-esteem

Reporting Suspected Child Abuse

Each state has specific agencies to receive and investigate reports of suspected child abuse and neglect. Usually, this is done by child protective services (CPS) within a Department of Social Services, Department of Human Resources, or Division of Family and Children Services. A list of that contact information is at the end of this course.

In some states, police departments also may receive reports of child abuse or neglect. If you do not know whom to call, you can call Childhelp USA, National Child Abuse Hotline at 1-800-4-A-CHILD (1-800-422-4453; TDD 1-800-2-A-CHILD). This Hotline is available 24 hours, seven days a week. They can tell you where to file your report and help you make the report. State Toll-Free Child Abuse

Child abuse victims frequent contact with health professionals, but only injuries are often treated. Because there is a lack of training on what to look for and how to ask about abuse, health professionals often fail to identify victims. Opportunities for intervention are missed, and victims continue to suffer the adverse health consequences of physical and emotional abuse

Healthcare professionals are often the first to observe abuse and neglect, and their observations are often crucial in substantiating that abuse has occurred. They can help by:

  • Reporting suspected cases of child abuse to Children's Protective Services
  • Documenting abuse in the medical record
  • Safeguarding evidence
  • Providing medical advice, referrals, and safety planning
  • Showing empathy and compassion
  • Identifying the somatic signs and symptoms of abuse
  • Evaluating the plausibility of explanations given for common injuries and conditions
  • Providing expert testimony
  • Assessing the cognitive status and health factors that affect it
  • Treating injuries or health problems that result from abuse
  • Performing abuse screenings
  • Encouraging clinics, hospitals, health maintenance organizations, or other medical providers to develop or adopt protocols for screening and responding to abuse
  • Provide referrals to legal and social services
  • Learning more about child abuse

Talking with Children

The healthcare professional's role is to assess for reasonable cause to suspect maltreatment/neglect or abuse. The healthcare professional is not to investigate or interrogate. The healthcare professional identifies the reasonable cause and leaves the investigation and interrogation to specially trained child protective services or law enforcement workers.

When talking with children to establish reasonable cause to suspect abuse or maltreatment/neglect, find a private place, and remain calm. Be honest, open, and upfront with the child. Be supportive. Listen to the child and stress that it is not the child's fault. Do not overreact, make judgments, make promises, nor interrogate or investigate.

What Is Reasonable Cause to Suspect Abuse or Maltreatment

Reasonable cause to be suspicious based on what you have observed or been told, combined with your training and experience, you feel that harm or imminent danger of harm to the child could result from an act or omission by the person legally responsible for the child. There is reasonable cause to suspect the child is being abused or maltreated.

Crimes committed against the child should be reported directly to law enforcement. If the child is in imminent danger, contact law enforcement immediately. Imminent danger is when the child is placed at immediate or substantial risk of harm.

Case Studies

A. A female, age 15, has comes to the ER with the rash on her vaginal area. She discloses she has been engaging in sexual intercourse with her mother’s 38-year-old boyfriend for the past two months. The boyfriend has resided in the house with the child and her mother for the past five years and is responsible for the care of the child when the mother is at work.

  • What indicators are present?
  • Is there a reasonable cost to suspect abuse or maltreatment?
  • What are your next steps?

B. Seven-year-old Chris came to the doctor’s office for a physical. He has a bruise on the right side of his face with scrapes along his right arm. The child claimed he fell off his bike. The child lives with his mother, a single parent. She says Chris is a very active child and at times can present challenging behaviors at school.

  • What indicators are present?
  • Is there a reasonable cost to suspect abuse or maltreatment?
  • What are your next steps?

C. A mother delivers a baby that has neonatal drug withdrawal. When talking to the mother, you learned she has not prepared for a baby to come home.

  • What indicators are present?
  • Is there a reasonable cost to suspect abuse or maltreatment?
  • What are your next steps?

D. Eight-year-old Jason comes to the ER with a broken arm. His mother says he fell off the bed. When Jason’s arm is x-rayed there’s a spiral fracture to his humerus.

  • What indicators are present?
  • Is there a reasonable cost to suspect abuse or maltreatment?
  • What are your next steps?

Case Study Answers

Case Study A

  • What indicators are present? Sexual abuse and verbal disclosure
  • Is there reasonable cause to suspect abuse or maltreatment? Yes
  • What are your next steps? Report abuse, maltreatment, or neglect

Case Study B

  • What indicators are present? Bruises, scrapes
  • Is there reasonable cause to suspect abuse or maltreatment? No, the story is consistent with a bike injury. Injuries sustained in an accidental fall would be along one side of the child’s body.
  • What are your next steps? Treat child’s injury.

Case Study C

  • What indicators are present? Neonatal drug withdrawal and no plan for the baby
  • Is there reasonable cause to suspect abuse or maltreatment? Yes
  • What are your next steps? Report abuse, maltreatment, or neglect

Case Study D

  • What indicators are present? Spiral fracture, explanation is not plausible
  • Is there reasonable cause to suspect abuse or maltreatment? Yes
  • What are your next steps? Report abuse, maltreatment, or neglect

Child Abuse Reporting Contact Information

Reporting Numbers Resource List is from Child Welfare Information Gateway (CWIG, nd):

Alabama Department of Human Resources
50 North Ripley Street
Montgomery, Alabama 36130
Phone: (334) 242-1325
Email: fsd@dhr.alabama.gov
 

Alaska Department of Health and Social Services
130 Seward Street
Suite 400
Juneau, Alaska 99811
Phone: (907) 465-3548
Email: ReportChildAbuse@alaska.gov
 

Arizona Department of Child Safety
3737 N. 7th Street
Suite 209
Phoenix, Arizona 85014
Phone: (602) 277-7292
Toll-Free: (800) 872-2879
Fax: (602) 277-7312
Non-emergency cases:
 

Arizona Department of Economic Security
CPS Family Advocate
Phone: (602) 364-0777
Toll-Free: (877) 527-0765
 

Arkansas Department of Human Services
Client Advocate
Donaghey Plaza, PO Box 1437
Little Rock, Arkansas 72203
Phone: (501) 683-2735
 

California Department of Social Services
744 P Street, M/S 3-90
Sacramento, California 95814
Phone: (916) 651-8100
 

California Ombudsman for Foster Care
744 P Street, MS 8-13-25
Sacramento, California 95814
Toll-Free: (877) 846-1602

Email: fosteryouthhelp@dss.ca.gov
 

Colorado Department of Human Services
1575 Sherman Street
Denver, Colorado 80203
Phone: (303) 866-4511
Fax: (303) 866-5563
Email: cdhs.communcations@state.co.us
Office of the Child Protection Ombudsman
Phone: (303) 864-5111
 

Connecticut Department of Children & Families
Ombudsman Office
505 Hudson Street
Hartford, Connecticut 06106
Phone: (860) 550-6301
Toll-Free: (866) 637-4737
Fax: (860) 560-7086

District of Columbia Child and Family Services Agency Youth Ombudsman
200 I Street, SE
Washington, District of Columbia 20003
Phone: (202) 442-6100
Fax: (202) 727-6505
Email: cfsa@dc.gov
 

Florida Department of Children and Families
County Client Relations’ Coordinators
Phone: (850) 487-1111
 

Georgia's Office of Child Advocate
270 Washington Street S.W.
8th Floor, Suite 8101
Atlanta, Georgia 30334
Phone: (404) 656-4200
Fax: (404) 656-5200
Email: tboga@oca.ga.gov
 

Hawaii Office of the Ombudsman
465 South King Street, 4th Floor
Honolulu, Hawaii 96813
Phone: (808) 587-0770
Fax: (808) 587-0773
 

Illinois Advocacy Office for Children and Families
406 East Monroe Street
Springfield, Illinois 62701
Phone: (217) 524-2029
Toll-Free: (800) 232-3798
TTY: (800) 513-4980
 

Indiana Department of Child Services (DCS) Ombudsman Bureau
402 W. Washington, W479
Indianapolis, Indiana 46204
Phone: (317) 234-7295
Email: DCSOmbudsman@idoa.in.gov
 

Iowa Office of Citizens' Aide Ombudsman
Ola Babcock Miller Building
1112 East Grand
Des Moines, Iowa 50319
Phone: (515) 281-3592
Toll-Free: (888) 426-6283
 

Kansas Department of Children and Families - Foster Parent and Youth Ombudsman
Toll-Free: (844) 279-2306
Email: fosterparent@dcf.ks.gov
 

Kentucky Cabinet for Health and Family Services
Office of the Ombudsman
275 East Main Street, 1E-B
Frankfort, Kentucky 40621
Phone: (502) 564-5497
Toll-Free: (800) 372-2973
Email: AndreaT.Day@ky.gov
 

Louisiana Department of Children & Family Services
627 North Fourth Street
Baton Rouge, Louisiana 70802
Phone: (225) 342-2297
Fax: (225) 342-2268
 

Maine Ombudsman Program
Maine Child Wel­fare Ser­vices Ombuds­man
Phone: (207) 213-4773
Toll-Free: (866) 621-0758
Email: ombudsman@cwombudsman.com
 

Maryland Department of Human Resources
State Constituent Services
311 West Saratoga Street
Baltimore, Maryland 21201-3521
Toll-Free: (800) 332-6347
Email: dhr-help@dhr.state.md.us
 

Massachusetts Department of Children and Families Ombudsman
24 Farnsworth Street
Boston, Massachusetts 02210
Phone: (617) 748-2444
 

Michigan Office of Children’s Ombudsman
P.O. Box 30026
Lansing, Michigan 48909
Phone: (517) 373-3077
Toll-Free: (800) 642-4326
Fax: (517) 335-4471
Email: childombud@michigan.gov
 

Minnesota - The Office of the Ombudsperson for Families
1450 Energy Drive
Suite 106
St. Paul, Minnesota 55108
Phone: (651) 603-0058
Toll-Free: 1-888-234-4939
Fax: (651) 643-2539
 

Mississippi Department of Human Services
Office of Consumer Services
750 North State Street
Jackson, Mississippi 39202
Phone: (601) 359-4414
Toll-Free: (800) 345-6347
Email: consumer.services@mdhs.ms.gov
 

Missouri Office of Child Advocate
PO Box 809
Jefferson City, Missouri 65102
Toll-Free: (866) 457-2302
Fax: (573) 522-6870
Email: oca@oca.mo.gov
 

Montana Child and Family Ombudsman
Helena, Montana 59604
Toll-Free: (844) 252-4453
Email: DOJOMBUDSMAN@mt.gov
 

Nebraska Public Counsel (Ombudsman's Office)
Public Counsel (Ombudsman's Office)
PO Box 94604
Room 807, State Capitol
Lincoln, Nebraska 68509-4604
Phone: (402) 471-2035
Toll-Free: (800) 742-7690
Email: ombud@leg.ne.gov
 

Nevada Division of Child and Family Services
Systems Advocate
4126 Technology Way, 3rd Floor
Carson City, Nevada 89706
Phone: (775) 684-4453
Email: systems.advocate@dcfs.nv.gov
 

New Hampshire Department of Health and Human Services
Office of the Ombudsman
129 Pleasant Street
Concord, New Hampshire 03301-3857
Phone: (603) 271-6941
Toll-Free: (800) 852-3345
Fax: (603) 271-4632
 

New Jersey Department of Children and Families
Office of Advocacy
222 South Warren Street
PO Box 729, 3rd Floor
Trenton, New Jersey 08625-0729
Toll-Free: (877) 543-7864
Email: askDCF@dcf.state.nj.us
 

New Mexico Children, Youth & Families
PO Drawer 5160
P.E.R.A. Room 254
Santa Fe, New Mexico 87502
Phone: (505) 827-7606
Fax: (505) 827-4053
Email: harry.montoya@state.nm.us
 

New York State Office of Children and Families
New York City Only
Office of Advocacy/ACS Parents' and Children's Rights Unit
150 William Street - 18th Floor
New York, New York 10038
Phone: (212) 676-9421
 

North Dakota Department of Human Services
Appeals Supervisor, Legal Advisory Unit
600 E Boulevard Avenue, Dept. 325
Bismarck, North Dakota 58505-0250
Phone: (701) 328-2311
Toll-Free: (800) 472-2622
Email: dhslau@nd.gov
 

Ohio Department of Job and Family Services
Office of Constituent Affairs
30 East Broad Street
32nd Floor
Columbus, Ohio 43215-0423
Phone: (614) 466-9280
Email: legislation@jfs.ohio.gov
 

Oklahoma Department of Human Services
Office of Client Advocacy
PO Box 25352
Oklahoma City, Oklahoma 73125-0352
Phone: (405) 525-4850
Fax: (405) 525-4855
 

Oregon Governor's Advocacy/Ombudsman Office
500 Summer St, NE
4th Floor GAO
Salem, Oregon 97301
Phone: (503) 945-6904
Toll-Free: (800) 442-5238
Email: dhs.info@state.or.us
 

Oregon Foster Care Ombudsman
500 Summer St. NE E-17
Salem, Oregon 97301
Fax: (855) 840-6036
Email: fco.info@state.or.us
 

Pennsylvania Department of Human Services
Rhode Island Office of the Child Advocate
Louis Pastor Building 4th Floor
57 Howard Avenue
Cranston, Rhode Island 02920
Phone: (401) 462-4300
Fax: (401) 462-4305
 

South Carolina State Office of Children's Affairs
Office of Children's Affairs
1200 Senate Street, Suite 104
Columbia, South Carolina 29201
Phone: (803) 734-5049
Fax: (803) 734-0799
 

South Dakota Department of Social Services
Constituent Liaison
700 Governor's Drive
Pierre, South Dakota 57501
Toll-Free: (800) 597-1603
Email: DSSConstituentLiaison@state.sd.us
 

Tennessee Commission on Children and Youth
Andrew Johnson Tower, 9th Floor
710 James Robertson Parkway
Nashville, Tennessee 37243-0800
Phone: (615) 532-1572
Toll-Free: (800) 264-0904
Fax: (615) 532-1591
 

Texas Department of Family and Protective Services
Office of Consumer Affairs
PO Box 149030
Austin, Texas 78714-9030
Toll-Free: (800) 720-7777
Fax: (512) 339-5892
Email: oca@dfps.state.tx.us
 

Texas Health and Human Services Commission
Office of the Ombudsman
PO Box 13247 -- MC H-700
Austin, Texas 78711-3247
Toll-Free: (877) 787-8999
TDD: (888) 425-6889
Fax: (888) 780-8099
 

Utah Department of Human Services
Office of Child Protection Ombudsman
120 North 120 200 West
Room 422 - PO Box 45500
Salt Lake City, Utah 84145-0500
Phone: (801) 538-4589
Toll-Free: (800) 868-6413
Fax: (801) 538-3942
 

Vermont Department for Children and Families
Consumer Concerns Team
103 South Main Street - 2nd Floor, 5 North
Waterbury, Vermont 05671-5920
Phone: (802) 871-3385
 

Virginia Department of Social Services 801 East Main Street
Richmond, Virginia 23219-3301
Phone: (804) 726-7011
Fax: (804) 726-7015
Email: comm@dss.virginia.gov
 

Washington State Office of the Family & Children's Ombuds
6720 Fort Dent Way, Suite 240
Mail Stop TT-99
Tukwila, Washington 98188
Phone: (206) 439-3870
Toll-Free: (800) 571-7321
Fax: (206) 439-3877
 

West Virginia Department of Health and Human Resources
Office of Client Services
350 Capital Street - Room 513
Charleston, West Virginia 25301
Toll-Free: (800) 642-8589
 

Wisconsin Department of Children and Families
201 East Washington Avenue, Second Floor
PO Box 8916
Madison, Wisconsin 53708-8916
Phone: (608) 267-3905
Fax: (608) 266-6836
Email: dcfweb@wisconsin.gov
 

Wyoming Department of Family Services
Complaint Resolution/Ombudsman
Hathaway Building - 2300 Capitol Avenue, 3rd Floor
Cheyenne, Wyoming 82002
Phone: (307) 777-6031
Toll-Free: (800) 457-3659
Fax: (307) 777-7747
Email: Kristie.langley@wyo.gov

Select one of the following methods to complete this course.

Take TestPass an exam testing your knowledge of the course material.
OR
Reflect on Practice ImpactDescribe how this course will impact your practice.   (No Test)

Implicit Bias Statement

CEUFast, Inc. is committed to furthering diversity, equity, and inclusion (DEI). While reflecting on this course content, CEUFast, Inc. would like you to consider your individual perspective and question your own biases. Remember, implicit bias is a form of bias that impacts our practice as healthcare professionals. Implicit bias occurs when we have automatic prejudices, judgments, and/or a general attitude towards a person or a group of people based on associated stereotypes we have formed over time. These automatic thoughts occur without our conscious knowledge and without our intentional desire to discriminate. The concern with implicit bias is that this can impact our actions and decisions with our workplace leadership, colleagues, and even our patients. While it is our universal goal to treat everyone equally, our implicit biases can influence our interactions, assessments, communication, prioritization, and decision-making concerning patients, which can ultimately adversely impact health outcomes. It is important to keep this in mind in order to intentionally work to self-identify our own risk areas where our implicit biases might influence our behaviors. Together, we can cease perpetuating stereotypes and remind each other to remain mindful to help avoid reacting according to biases that are contrary to our conscious beliefs and values.

References

  • World Health Organization, 2020. Prevention of Child Maltreatment retrieved 3/11/20. Visit Source.
  • U.S. Department of Health & Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children's Bureau. Child Maltreatment 2018. 1/15/20. Retrieved 3/11/20. Visit Source.
  • Research foundation for SUNY (2011). Mandated reporter trainer's resource guide; identifying and reporting child abuse and maltreatment/neglect. Buffalo State College, Center for development of human services, 2011.
  • AbuseWatch.net (nd) Prevention Resources for the Community and Professionals Retrieved 3/11/20. Visit Source.
  • Child Welfare Information Gateway. (nd). State Child Abuse and Neglect Reporting Numbers retrieved 3/11/20. Visit Source.