The purpose of this course is to prepare healthcare professionals to identify child abuse and maltreatment/neglect and to comply with Pennsylvania mandatory reporting requirements.
After completing this course, the learner will be able to:
Violence is an important public health issue. The World Health Organization (WHO) estimates that nearly 53,000 children are murdered each year and that 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, 2016).
For 2014, there were a nationally estimated 702,000 victims of abuse and neglect, resulting in a rate of 9.4 victims per 1,000 children in the population. The youngest children are the most vulnerable to maltreatment. In FFY 2014, 52 states reported that more than one-quarter (27.4%) of victims were younger than 3 years. (DHHS, 2014, pg. 21).
The percentages (not shown) of child victims were similar for both boys (48.9) and girls (50.7). African-American children had the highest rate of victimization at 15.3 per 1,000 children in the population of the same race or ethnicity, and American Indian or Alaska Native children had the second highest rate at 13.4 per 1,000 children. Hispanic and White children had lower rates of victimization at 8.8 and 8.4 per 1,000 children in the population of the same race or ethnicity (DHHS, 2014, pg. 23).
For FFY 2014, a nationally estimated 1,580 children died from abuse and neglect at a rate of 2.13 per 100,000 children in the population (DHHS, 2014, pg. 51).
In Pennsylvania in 2012, suspected child abuse was reported for about 10 per 1000 children. Those reports were substantiated for about one per 1000 children. 33 children died of abuse in 2012 and parents were the perpetrators in 60% of cases (PA CWS, 2015).
Studies conclude that professionals that have contact with children report only half of the incidents that may be abuse (Research foundation, 2011). The reason for this low report rate was:
The study also found the professionals are often influenced by their professional beliefs, values, and past experiences (Research foundation, 2011).
Protecting Pennsylvania’s children from abuse and neglect is a shared responsibility. It requires collaboration with the formal child protective services system, community partners, and our citizens to provide local safety nets for children and families that are facing challenges within our communities and neighborhoods.
Recently, 23 pieces of legislation were enacted, changing how Pennsylvania responds to child abuse. These changes significantly impact the reporting, investigation, assessment, prosecution and judicial handling of child abuse and neglect cases.
This website, KeepKidsSafe.pa.gov, is designed to serve as the hub for information related to critical components impacting child protection including a link for mandated reporters to make reports of suspected child abuse electronically, training on child abuse recognition and reporting, information related to clearances and general information related to child protection (Keep Kids Safe PA, 2015, homepage).
The Pennsylvania Child Protective Services Law (CPSL) was signed into law in 1975. It was enacted to protect children from abuse, allow the opportunity for healthy growth and development, and, whenever possible, preserve and stabilize the family.
The primary focus of Pennsylvania’s Child Welfare System is the safety, permanency, and well-being of the children we serve. We operate from the assumption that children belong with their own families and should receive necessary services in the community rather than being placed outside of their homes. Although placement away from their families should be the last resort, if it is necessary, children should be placed in the most appropriate setting to meet their needs, preferably, a location that promotes reunification with the family where, and as soon as, possible (Mackereth B., 2013, pg. 2).
The Child Welfare System (CWS) in Pennsylvania is state supervised and county administered.
The Department of Human Services is responsible for (Mackereth B., 2013):
The county children and youth agency is responsible for (Mackereth B., 2013):
Each county’s children and youth social service agency is responsible for administering a program of children and youth social services to children and their families. The county children and youth social service program includes services designed to (Mackereth B., 2013, pg. 3):
Reports of child abuse will be made through ChildLine, but for your information, the following is the contact information for the regional state CWS agencies.
Office of Children, Youth and Families
801 Market Street, 6th Floor
Philadelphia, PA 19107
(215) 560-2249 or (215) 560-2823
Raheemah Shamsid-Deen Hampton, Director
Counties Served: Bucks, Chester, Delaware, Montgomery, Philadelphia
Office of Children, Youth and Families
11 Stanwix Street, Room 260
Pittsburgh, PA 15222
Elaine Bobick, Director
Counties Served: Allegheny, Armstrong, Beaver, Butler, Cameron,
Clarion, Clearfield, Crawford, Elk, Erie,
Fayette, Forest, Greene, Indiana, Jefferson,
Lawrence, McKean, Mercer, Potter, Venango,
Warren, Washington, Westmoreland
Office of Children, Youth and Families
Scranton State Office Building
100 Lackawanna Avenue, 3rd Floor
Scranton, PA 18503
Jacquly Maddon, Director
Counties Served: Berks, Bradford, Carbon, Lackawanna,
Lehigh, Luzerne, Monroe, Northampton,
Pike, Schuylkill, Sullivan, Susquehanna,
Tioga, Wayne, Wyoming
Office of Children, Youth and Families
1401 North Seventh Street, Fourth Floor
Harrisburg, PA 17120
Gabi Williams, Director
Counties Served: Adams, Bedford, Blair, Cambria, Centre,
Clinton, Columbia, Cumberland, Dauphin,
Franklin, Fulton, Huntingdon, Juniata, Lancaster,
Lebanon, Lycoming, Mifflin, Montour,
Northumberland, Perry, Snyder, Somerset,
Child Protective Services vs. General Protective Services
General Protective Services: Services and activities that are related to the safety of children including, but not limited to inadequate housing, clothing and supervision.
Child Protective Services: Services and activities that are provided for concerns of child abuse. Ways to identify abuse and the reporting processes are discussed later in this course.
The following are legal definitions that are important to understand in order to identify child abuse.
Child: An individual under 18 years of age.
The definition of perpetrator is used to determine if the case is child abuse. As a mandatory reporter, you should report any situation. If the abuser does not meet the definition of perpetrator, the case will be referred to the appropriate agency or services by the CWS.
Perpetrator of Child Abuse:
Perpetrator of child abuse for failure to act
School Employee: An individual who is employed by a school or who provides a program, activity or service sponsored by a school. The term excludes an individual who has no direct contact with children.
If the alleged perpetrator is a school employee or child-care service employee, the administrator or employer will receive notice of a pending allegation and the final status of the report following the investigation as to whether the report is indicated, founded or unfounded. If the perpetrator is a school employee, the notice of the final status of the report shall be sent to the Department of Education within ten days of the completion of the investigation (Title23. Chapter 63. 23c6303s § 6340 (a)).
Act or failure to act: A perpetrator can cause the abuse (act) or can
§ 6303. (b.1) Child abuse.--The term "child abuse" shall mean intentionally, knowingly or recklessly doing any of the following:
(1) Causing bodily injury to a child through any recent act or failure to act.
(2) Fabricating, feigning or intentionally exaggerating or inducing a medical symptom or disease which results in a potentially harmful medical evaluation or treatment to the child through any recent act.
(3) Causing or substantially contributing to serious mental injury to a child through any act or failure to act or a series of such acts or failures to act.
(4) Causing sexual abuse or exploitation of a child through any act or failure to act.
(5) Creating a reasonable likelihood of bodily injury to a child through any recent act or failure to act.
(6) Creating a likelihood of sexual abuse or exploitation of a child through any recent act or failure to act.
(7) Causing serious physical neglect of a child.
(8) Engaging in any of the following recent acts:
(i) Kicking, biting, throwing, burning, stabbing or cutting a child in a manner that endangers the child.
(ii) Unreasonably restraining or confining a child, based on consideration of the method, location or the duration of the restraint or confinement.
(iii) Forcefully shaking a child under one year of age.
(iv) Forcefully slapping or otherwise striking a child under one year of age.
(v) Interfering with the breathing of a child.
(vi) Causing a child to be present at a location while a violation of 18 Pa.C.S. § 7508.2 (relating to operation of methamphetamine laboratory) is occurring, provided that the violation is being investigated by law enforcement.
(vii) Leaving a child unsupervised with an individual, other than the child's parent, who the actor knows or reasonably should have known:
(A) Is required to register as a Tier II or Tier III sexual offender under 42 Pa.C.S. Ch. 97 Subch. H (relating to registration of sexual offenders), where the victim of the sexual offense was under 18 years of age when the crime was committed.
(B) Has been determined to be a sexually violent predator under 42 Pa.C.S. § 9799.24 (relating to assessments) or any of its predecessors.
(C) Has been determined to be a sexually violent delinquent child as defined in 42 Pa.C.S. § 9799.12 (relating to definitions).
(9) Causing the death of the child through any act or failure to act.
Engaging a child in a severe form of trafficking in persons or sex trafficking, as those terms are defined under section 103 of the Trafficking Victims Protection Act of 2000.
Recent act or failure to act: Any act or failure to act committed within two years of the date of the report to the department or county agency.
Serious bodily injury: Bodily injury which creates a substantial risk of death or which causes serious permanent disfigurement or protracted loss or impairment of function of any bodily member or organ.
§ 6303. (b) "Sexual abuse or exploitation." Any of the following:
(1) The employment, use, persuasion, inducement, enticement or coercion of a child to engage in or assist another individual to engage in sexually explicit conduct, which includes, but is not limited to, the following:
(i) Looking at the sexual or other intimate parts of a child or another individual for the purpose of arousing or gratifying sexual desire in any individual.
(ii) Participating in sexually explicit conversation either in person, by telephone, by computer or by a computer-aided device for the purpose of sexual stimulation or gratification of any individual.
(iii) Actual or simulated sexual activity or nudity for the purpose of sexual stimulation or gratification of any individual.
(iv) Actual or simulated sexual activity for the purpose of producing visual depiction, including photographing, videotaping, computer depicting or filming.
This paragraph does not include consensual activities between a child who is 14 years of age or older and another person who is 14 years of age or older and whose age is within four years of the child's age.
(2) Any of the following offenses committed against a child:
(i) Rape as defined in 18 Pa.C.S. § 3121 (relating to rape).
(ii) Statutory sexual assault as defined in 18 Pa.C.S. § 3122.1 (relating to statutory sexual assault).
(iii) Involuntary deviate sexual intercourse as defined in 18 Pa.C.S. § 3123 (relating to involuntary deviate sexual intercourse).
(iv) Sexual assault as defined in 18 Pa.C.S. § 3124.1 (relating to sexual assault).
(v) Institutional sexual assault as defined in 18 Pa.C.S. § 3124.2 (relating to institutional sexual assault).
(vi) Aggravated indecent assault as defined in 18 Pa.C.S. § 3125 (relating to aggravated indecent assault).
(vii) Indecent assault as defined in 18 Pa.C.S. § 3126 (relating to indecent assault).
(viii) Indecent exposure as defined in 18 Pa.C.S. § 3127 (relating to indecent exposure).
(ix) Incest as defined in 18 Pa.C.S. § 4302 (relating to incest).
(x) Prostitution as defined in 18 Pa.C.S. § 5902 (relating to prostitution and related offenses).
(xi) Sexual abuse as defined in 18 Pa.C.S. § 6312 (relating to sexual abuse of children).
(xii) Unlawful contact with a minor as defined in 18 Pa.C.S. § 6318 (relating to unlawful contact with minor).
(xiii) Sexual exploitation as defined in 18 Pa.C.S. § 6320 (relating to sexual exploitation of children).
Human Trafficking: The recruitment, harboring, transportation, provision or obtaining of a child for labor or services through the use of force, fraud, or coercion. Under federal law, sex trafficking (such as prostitution, pornography, exotic dancing, etc.) does not require there be force, fraud or coercion if the victim is under 18.
Sex Trafficking in which a commercial sex act is induced by force, fraud, or coercion,
Commercial sex act: means any sex act on account of which anything of value is given to or received by any person.
At risk youth population for human trafficking
Victim identification/warning signs are but not limited to”
"Serious mental injury." A psychological condition, as diagnosed by a physician or licensed psychologist, including the refusal of appropriate treatment, that:
(1) renders a child chronically and severely anxious, agitated, depressed, socially withdrawn, psychotic or in reasonable fear that the child's life or safety is threatened; or
(2) seriously interferes with a child's ability to accomplish age-appropriate developmental and social tasks.
"Serious physical neglect." Any of the following when committed by a perpetrator that endangers a child's life or health, threatens a child's well-being, causes bodily injury or impairs a child's health, development or functioning:
(1) A repeated, prolonged or egregious failure to supervise a child in a manner that is appropriate considering the child's developmental age and abilities.
(2) The failure to provide a child with adequate essentials of life, including food, shelter or medical care.
Exclusions to Child Abuse (Title23. Chapter 63. 23c6303s
§ 6303, 2015).
***It is NOT a reporter’s responsibility to determine if the person who allegedlycommitted child abuseor harm to a child is a perpetrator. Exclusions will be applied when substantiating a report, not when making a report.
§ 6304. Exclusions from child abuse.
(a) Environmental factors.--No child shall be deemed to be physically or mentally abused based on injuries that result solely from environmental factors, such as inadequate housing, furnishings, income, clothing and medical care, that are beyond the control of the parent or person responsible for the child's welfare with whom the child resides. This subsection shall not apply to any child-care service as defined in this chapter, excluding an adoptive parent.
(b) Practice of religious beliefs.--If, upon investigation, the county agency determines that a child has not been provided needed medical or surgical care because of sincerely held religious beliefs of the child's parents or relative within the third degree of consanguinity and with whom the child resides, which beliefs are consistent with those of a bona fide religion, the child shall not be deemed to be physically or mentally abused. In such cases the following shall apply:
(1) The county agency shall closely monitor the child and the child's family and shall seek court-ordered medical intervention when the lack of medical or surgical care threatens the child's life or long-term health.
(2) All correspondence with a subject of the report and the records of the department and the county agency shall not reference child abuse and shall acknowledge the religious basis for the child's condition.
(3) The family shall be referred for general protective services, if appropriate.
(4) This subsection shall not apply if the failure to provide needed medical or surgical care causes the death of the child.
(5) This subsection shall not apply to any child-care service as defined in this chapter, excluding an adoptive parent.
(c) Use of force for supervision, control and safety purposes.--Subject to subsection (d), the use of reasonable force on or against a child by the child's own parent or person responsible for the child's welfare shall not be considered child abuse if any of the following conditions apply:
(1) The use of reasonable force constitutes incidental, minor or reasonable physical contact with the child or other actions that are designed to maintain order and control.
(2) The use of reasonable force is necessary:
(i) to quell a disturbance or remove the child from the scene of a disturbance that threatens physical injury to persons or damage to property;
(ii) to prevent the child from self-inflicted physical harm;
(iii) for self-defense or the defense of another individual; or
(iv) to obtain possession of weapons or other dangerous objects or controlled substances or paraphernalia that are on the child or within the control of the child.
(d) Rights of parents.--Nothing in this chapter shall be construed to restrict the generally recognized existing rights of parents to use reasonable force on or against their children for the purposes of supervision, control and discipline of their children. Such reasonable force shall not constitute child abuse.
(e) Participation in events that involve physical contact with child.--An individual participating in a practice or competition in an interscholastic sport, physical education, a recreational activity or an extracurricular activity that involves physical contact with a child does not, in itself, constitute contact that is subject to the reporting requirements of this chapter.
(f) Child-on-child contact.--
(1) Harm or injury to a child that results from the act of another child shall not constitute child abuse unless the child who caused the harm or injury is a perpetrator.
(2) Notwithstanding paragraph (1), the following shall apply:
(i) Acts constituting any of the following crimes against a child shall be subject to the reporting requirements of this chapter:
(A) rape as defined in 18 Pa.C.S. § 3121 (relating to rape);
(B) involuntary deviate sexual intercourse as defined in 18 Pa.C.S. § 3123 (relating to involuntary deviate sexual intercourse);
(C) sexual assault as defined in 18 Pa.C.S. § 3124.1 (relating to sexual assault);
(D) aggravated indecent assault as defined in 18 Pa.C.S. § 3125 (relating to aggravated indecent assault);
(E) indecent assault as defined in 18 Pa.C.S. § 3126 (relating to indecent assault); and
(F) indecent exposure as defined in 18 Pa.C.S. § 3127 (relating to indecent exposure).
(ii) No child shall be deemed to be a perpetrator of child abuse based solely on physical or mental injuries caused to another child in the course of a dispute, fight or scuffle entered into by mutual consent.
(iii) A law enforcement official who receives a report of suspected child abuse is not required to make a report to the department under section 6334(a) (relating to disposition of complaints received), if the person allegedly responsible for the child abuse is a non-perpetrator child.
(g) Defensive force.--Reasonable force for self-defense or the defense of another individual, shall not be considered child abuse. 23c6304v
Exclusions are used when evaluating a case in order to substantiate the report. However, a mandatory reporter’s responsibility is to report suspected abuse. If the mandatory reporter is unsure, a report should be filed. The CWS will conduct an investigation and determine that child abuse did not occur if the case meets exclusion criteria.
Senate Bill 1311 was signed by Governor Wolf on October 28, 2016, and is now known as Act 115 of 2016. Act 115 was immediately effective and amends Titles 23 (Domestic Relations) and 42 (Judiciary and Judicial Procedure) of the Pennsylvania Consolidated Statutes by: providing for additional grounds for involuntary termination of parental rights; providing for an additional grounds for aggravated circumstances; allowing for release of information in confidential reports to law enforcement when investigating cases of severe forms of trafficking in persons of sex trafficking; adding a category of child abuse to include: engaging a child in a severe form of trafficking in persons or sex trafficking, as those terms are defined under section 103 of the Trafficking Victims Protection Act of 2000; and adding a category of perpetrator to include: an individual 18 years of age or older who engages a child in severe forms of trafficking in persons or sex trafficking, as those terms are defined under section 103 of the Trafficking Victims Protection Act of 2000.
Anyone (permissive reporter) may report suspected abuse at any time and are encouraged to do so.
However, Title23. Chapter 63. 23c6303s
§ 6311 (a) requires the following adults are mandated to report suspension of child abuse:
A person licensed or certified to practice in any health-related field under the jurisdiction of the Department of State.
A medical examiner, coroner or funeral director.
An employee of a health care facility or provider licensed by the Department of Health, who is engaged in the admission, examination, care or treatment of individuals.
A school employee.
An employee of a child-care service who has direct contact with children in the course of employment.
A clergyman, priest, rabbi, minister, Christian Science practitioner, religious healer or spiritual leader of any regularly established church or other religious organization.
An individual paid or unpaid, who, on the basis of the individual's role as an integral part of a regularly scheduled program, activity or service, is a person responsible for the child’s welfare or has direct contact with children.
An employee of a social services agency who has direct contact with children in the course of employment.
A peace officer or law enforcement official.
An emergency medical services provider certified by the Department of Health.
An employee of a public library who has direct contact with children in the course of employment.
An individual supervised or managed by a person listed under paragraphs 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, and 13, who has direct contact with children in the course of employment.
An independent contractor who has direct contact with children.
An attorney is a mandated reporter if he/she is affiliated with an agency, institution, organization or other entity, including a school or regularly established religious organization that is responsible for the care, supervision, guidance or control of children.
A foster parent.
Many mandated reporters feel there is a conflict between their legal obligation to report and their legal obligation to maintain client or patient confidentiality. Title23. Chapter 63. 23c6303s
§ 6311 (a) states that privileged communications does not apply to a situation involving child abuse. Additionally, privileged communication between a mandated reporter and a client does not relieve the mandated reporter of the duty to make a report of suspected child abuse.
Exceptions are (Title23. Chapter 63. 23c6303s
§ 6311 (b), 2015).
Confidential communications made to a member of the clergy are protected under 42 PA.C.C §5943
Confidential communications made to an attorney are protected so long as they are within the scope of 42 PA.C.S. §§ 5916 (relating to confidential communications to attorney) and 5928 (relating to confidential communications to attorney), the attorney work product doctrine or the rules of professional conduct for attorneys.
If a child is in immediate danger, call 911.
The mandated reporter is required to report even if their knowledge is incomplete. The role of the mandated reporter is to assess for reasonable cause to suspect abuse. The mandated reporter identifies reasonable cause and leaves the investigation to specially trained workers in the CWS.
The mandated reporter does not:
When talking with children to establish reasonable cause, find a private place and remain calm. Be honest, opening, and up front with the child. Be supportive. Listen to the child and stress that it’s not the child’s fault. Do not overreact, make judgments, make promises, nor interrogate or investigate.
There is no legal requirement to inform the parent or other persons legally responsible for the child care that you are making a report to ChildLine. In fact, informing the parents of the report may place the child for the risk of harm. Do not assume that the parent will support the child.
In the case of suspected sexual abuse, avoid talking in detail with the child about the incident. There are special guidelines that apply to the case of suspected sexual abuse. Usually CWS and law enforcement work together to interview the child same time using specially trained professionals.
Reasonable cause to suspect things that 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 be the result of an act or omission by the person legally responsible for the child. If there is reasonable cause to suspect the child is being abused or maltreated you must call ChildLine immediately (Research Foundation, 2011, pg. 26).
Mandated reporters are required to make a report of suspected child abuse if they have reasonable cause to suspect that a child is a victim of child abuse under any of the following circumstances:
It is not required that the child come before the mandated reporter in order to make a report of suspected child abuse.
Crimes committed against the child should be reported directly to law enforcement. If you’re uncertain if the incidence criminal, you can contact the CWS anyway. If the child is in imminent danger, contact law enforcement immediately. Imminent danger is when the child is placed at immediate risk or a substantial risk of harm. In other words, how direct is the threat to the child the danger must be immediate or nearly immediate (Research foundation, 2011).
1. Reports must be made immediately upon development of reasonable cause to suspect child abuse. Reports should be made by the person with knowledge of the reasonable cause.
2. The person in charge of the institution, school, facility or agency or the designated agent of the person in charge should be notified of the report immediately after making the report to ChildLine.
No more than one report from any institution school or agency is required, but the report should include names and contact information of everyone who has knowledge of the situation.
Reports of child abuse may be reported to ChildLine electronically at www.compass.state.pa.us/cwis if the situation does not require an emergency response.
You should call the Child Abuse Hotline, ChildLine at 1-800-932-0313 for the following situations:
If an oral report is made to ChildLine, a report of suspected child abuse, form CY 47, must also be completed and forwarded to the county children and youth agency within 48 hours after making the report. This form can be obtained at www.KeepKidsSafe.pa.gov under the forms tab or from the children and youth agency.
If a report is made electronically, no CY-47 is required to be completed (PA CWS, FAQ, 2015).
Specific case studies are presented later in this course.
Be prepared to articulate your concerns in a clear and concise manner when you call ChildLine. The following is a list of information the mandated reporter is asked to provide if known (Title23. Chapter 63. 23c6303s
§ 6311 (a), 2015):
The law requires that the mandated reporter identify themselves and where they can be reached. This information is helpful if the caseworker needs additional information. However, the identity of the person making the report is kept confidential with the exception of being released to law enforcement officials or the district attorney’s office (PA, CWS, 2015).
Mandatory reporting and postmortem investigation of deaths (Title23. Chapter 63. 23c6303s
§ 6317, 2015).
A person or official required to report cases of suspected child abuse, including employees of a county agency, who has reasonable cause to suspect that a child died as a result of child abuse shall report that suspicion to the appropriate coroner or medical examiner. The coroner or medical examiner shall accept the report for investigation and shall report his finding to the police, the district attorney, the appropriate county agency and, if the report is made by a hospital, the hospital.
ChildLine forwards the report of suspected child abuse to the local county children and youth agency, which investigates the report to determine if the allegations can be substantiated as child abuse/neglect and also arranges for or provides the services that are needed to prevent the further maltreatment of the child and to preserve the family unit (PA CWS, FAQ, 2015). Services that are available include (Mackereth B., 2013):
The county children and youth agency must begin an investigation within 24 hours. The 24 hour deadline to begin investigation applies only to CPS cases. As it is NOT the reporter’s responsibility to determine if the alleged perpetrator meets the definition of a perpetrator as per the Child Protective Services Law, the reporter will be calling in some reports that could be CPS reports. This deadline does not apply to a CPS case. A thorough inquiry is conducted to determine if the child was abused and what services are appropriate for the child and family. This must be completed within 30 days unless the agency provides justification as to why the investigation cannot be completed, including attempts being made to obtain medical records or interview subjects of the report (PA CWS, FAQ, 2015).
If the alleged perpetrator report does not meet the definition of perpetrator, but does suggest the need for investigation, ChildLine will forward the information to the district attorney’s office in the respective county (PA CWS, 2015).
Mandated reporters are immune from any criminal or civil liability if the report was made in good faith. Good faith for mandated reporter is presumed. This means if someone accuses you of making a false report that they have to prove to you acted with gross negligence or willful misconduct (Research foundation, 2011).
A mandated reporter who willfully fails report can be found guilty of a misdemeanor of the second degree up to a felony of the first degree or higher. Failing to report may also result in a lawsuit in civil court for monetary damages for any harm that was caused by the mandated reporter’s failure to make a report ChildLine, including wrongful death (Research foundation, 2011).
Mandated reporters will receive information from the Department regarding the final status of the report, whether it was unfounded, indicated or founded, and the services planned or provided to protect the child (PA CWS, 2015).
Indicators of abuse warn the mandated reporter 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 indicators of abuse or maltreatment/neglect:
Indicators should not be viewed in isolation they must be considered in relationship 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 (Research foundation, 2011).
Some mandated reporters 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.
Common physical indicators are severe unexplained or suspicious bruises and welts, fractures, burns, lacerations, or abrasions. Specific physical indicators are (Research foundation, 2011, participant's guide pg. 6; NYOFS, 2016):
Glove like burn
Sock like burn
Steam Iron Injury
Looped cord injury (AbuseWatch.net, 2012)
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 bruises, and suspicious bruising areas, as well as other suspicious areas of injury.
Suspicious areas of bruising
Clues to the mechanism of injury
Consider the size and shape of the injury, as well as the location of injury (Research foundation, 2011). Consider the relationship of the mechanism of injury (explanation of how injury occurred) to the child's developmental stage. For example toddlers fall when they learn to walk and young children scrape their knees when learning to ride a bicycle. Consider if the story that was given as an explanation for an injury would produce the physical indicators that are present. For instance a toddler falls to the floor while walking, not striking anything when he fell. 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 (Research foundation, 2011, participant's guide pg. 6; NYOFS, 2016):
Parent behavioral indicators of physical abuse may be (Research foundation, 2011, participant's guide pg. 6; NYOFS, 2016):
Child physical indicators of emotional abuse, maltreatment, or neglect may be (Research foundation, 2011, pg. 7)(NYOFS, 2016):
Child behavioral indicators of emotional abuse, maltreatment, or neglect may be (Research foundation, 2011, pg. 7)(NYOFS, 2016):
Child physical indicators of sexual abuse may be (Research foundation, 2011, pg. 8) (NYOFS, 2016):
Child behavioral indicators of sexual abuse may be (Research foundation, 2011, pg. 8) (NYOFS, 2016):
Parent behavioral indicators of sexual abuse may be (Research foundation, 2011, pg. 8) (NYOFS, 2016):
A. Female, age 15, has comes to the ER with burning upon urination. 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 (Research foundation, 2011, pg. 15)..
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 (Research foundation, 2011, pg. 16).
C. A mother delivers a baby that has neonatal drug withdrawal. When talking to the mother, you learned she has not prepared for baby to come home (Research foundation, 2011, pg. 17).
D. Eight-year-old Jason comes to the ER with a broken arm. His mother says he fell off the bed. When Jason Jason’s arm is x-rayed there’s a spiral fracture to his humorous (Research foundation, 2011, pg. 18).
Case Study A
Case Study B
Case Study C
Case Study D
AbuseWatch.net (2012). Prevention Resources for the Community and Professionals. Retrieved May 5, 2013.
Keep Kids Safe PA (2015) Retrieved on 5/13/15.
Mackereth B. (2013) Department of Public Welfare. Overview of Pennsylvania’s Child Welfare System, Joint Hearing of the Senate Aging and Youth and the Senate Public Health and Welfare Committee April 9, 2013. Retrieved 5/11/15.
New York Office of Children and Family Services. (2016). Mandated Reporter Training Online. Retrieved 5/26/16.
Pennsylvania Child Welfare System (2015). Frequently Asked Questions About Child Abuse and Neglect retrieved 5/6/15.
Pennsylvania Child Welfare System (2015) Mandated Reporter Frequently Asked Questions Retrieved 5/6/15.
Pennsylvania Child Welfare System (2015) retrieved 5/11/15.
Pennsylvania Child Welfare Information Solution. (2015) retrieved 5/11/15.
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.
Title 23. CHAPTER 63 (2015) Child Protective Services. Pennsylvania general assembly retrieved on 2/6/15.
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World Health Organization, 2013. Prevention of Child Maltreatment, retrieved May 31, 2013.
This course is applicable for the following professions:
Advanced Registered Nurse Practitioner (ARNP), Athletic Trainer (AT/AL), Clinical Nurse Specialist (CNS), Licensed Practical Nurse (LPN), Licensed Vocational Nurses (LVN), Occupational Therapist (OT), Occupational Therapist Assistant (OTA), Physical Therapist (PT), Physical Therapist Assistant (PTA), Registered Nurse (RN), Respiratory Therapist (RT)
CPD: Preserve Safety