UNIT 3.7-3.12

abuse

any willful act or threatened act that results in any physical, mental, or sexual abuse, injury or harm that causes or is likely to cause a child’s physical, mental or emotional health to be significantly harmed

abuse maltreatment categories

• sexual abuse

• mental injury

• asphyxiation

• bizarre punishment

• bone fractures

• burns

• internal injuries

• physical injury by willful act

plausible threat of physical injury

means that the caregiver has acted, or is acting, in a manner that creates a probability of physical injury that would cause the child severe pain or significantly impair the child’s physical functioning either temporarily or permanently

factors to consider for physical injury maltreatment

1. the age of the child

2. any prior history of injuries to the child

3. the location of the injury on the body of the child

4. the multiplicity of the injury

5. the type of trauma inflicted

asphyxiation/suffocation/drowning maltreatment (physical injury)

-asphyxiation occurs when there is a lack of oxygen, while strangulation on the other hand is when breathing is impeded by strangulation

-drowning includes both intentional and accidental drowning

Bizarre punishment maltreatment

a willful act of discipline or punishment that includes inflicting or subjecting a child to intense physical or mental pain, suffering or agony that is repetitive, prolonged or severe

ex: tying limbs to bed, forcing child into cage, tying child’s penis to stop bedwetting…etc

Bone fracture maltreatment

-any inflicted broken bone in a child that is caused by the willful action of a parent/caregiver

Burns maltreatment

a tissue injury resulting from excessive exposure to thermal, chemical, electrical, or radioactive agents from the willful action of a parent/caregiver

internal injuries maltreatment

injury caused by a willful act by a caregiver to the organs occupying the thoracic, cranium or abdominal cavities that is not visible from the outside

-ex: brain/spinal cord damage, intra-cranial hemorrhage, shaken baby syndrome…etc

forms of sexual abuse

• exhibitionism (exposing oneself to a minor)

• fondling

• intercourse

• masturbation in presence of minor/forcing minor to masturbate

• obscene phone calls, texts or digital interaction

• producing, owning, or sharing porn images or movies of children

• sex of any kind with a minor

• any other sexual conduct that is harmful to a child mental, emotional or physical welfare

sexual abuse maltreatments

1. sexual battery: penetration of a child, forcing or allowing child to perform penetration, penetration of another person by any object

2. sexual molestation: intentional touching of genitals or intimate parts, or the clothing covering them

3. sexual exploitation: any other sexual act intentionally perpetrated in the presence or a child

romeo and juliet law

-close in age exemption that protects individuals from rape charges

-illegal for someone over the age of 24 to have sex with 16/17 year old

-legal for someone younger than 24 but older than 18

sexual abuse indicators

1. physical indicators: physical injury to the genitals, STDS, bladder/urinary tract infections, painful bowel movements or retention of feces, early unexplained pregnancy

2. behavioral indicators: verbal disclosure, precocious sexual knowledge and inappropriate behavior, prevalent generalized indicators of emotional distress

risk factors for child sexual abuse

1. gender (1/4 girls;1/20 boys)

2. age (7-13)

3. parental substance misuse (less likely to protect their children)

4. social isolation

5. history of abuse

6. proximity to perpetrators (91% of perpetrators are someone the child knows and trusts)

five phases of child sexual abuse

1. grooming phase: build trust with child, family or caregivers

2. testing phase: assess child’s boundaries and secrecy compliance

3. manipulation phase: employ emotional manipulation, threats, secrecy

4. sexual phase: engage in sexual acts

5. secrecy phase: emphasize secret keeping for control

What are the reasons a child might recant disclosure?

• secrecy and shame

• denial and coping

• lack of support and pressure

• societal attitudes

• interactions with professionals

• time and external factors

• control, fear and influence

• false beliefs and guilt

mental injury

an injury to the intellectual or psychological capacity of a child as evidenced by a discernible and substantial impairment in the ability to function within the normal range of performance and behavior

risks for mental injury

• excessive, aggressive, or unreasonable demands

• placing expectations on a child beyond the child’s capacity

• failure to provide nurturing necessary for growth

• not providing child with safe environment

• threatening child with violence or abandonment

• constantly criticizing or blaming the child for problems

• the child’s parent or caregiver does not show concern for the child and refuses help from others for the child

Neglect

when a child is actively deprived of or is allowed to be deprived of necessary food, clothing, shelter, or medical treatment, or when a child is permitted to live in an environment where such deprivation causes the child’s physical, mental, or emotional health to be significantly impaired or to be in danger of being impaired

Situational vs Chronic Neglect

situational: needs not met due to situational/circumstantial factors

chronic: a pattern of neglectful behavior that persists over time

Neglect maltreatments

• failure to protect

• environmental hazards

• inadequate supervision

• medical neglect

• failure to thrive/malnutrition/dehydration

failure to protect

occurs when a parent does not take reasonable measures to shield a child from harm or danger brought about by another individual

environmental hazards

living conditions or situations that create a significant threat to a child’s immediate safety or long term health due to the actions or non actions of the caregiver

-ex: drug labs, inadequate shelter, inadequate clothing or food

inadequate supervision

caregiver is leaving a child without adult supervision or arrangement appropriate for child’s age, maturity, developmental level or mental or physical condition

medical neglect

failure to provide or failure to allow needed care as recommended by a health care professional

-ex: failing to seek medical attention, refusing doctor’s treatment plan, ignoring or failing to treat chronic condition, failure to provide special needs care

-inadequate financial ability alone is not medical neglect

Failure to thrive

a serious, diagnosed, medical condition that is most often seen in young children. The child’s weight, length and head circumference falls significantly short of the normal lower parameters of typical children of that age.

-weight or height below the 5th percentile

-non organic FTT is parentally induced

T/F: for a report to be accepted a “Failure to Thrive/Malnutrition/Dehydration,” the allegations must come from medical or nursing personnel and cannot be due to an organic cause

True

Death Maltreatment

-maltreatment label of death when a child’s passing is believed to be the result of a caregiver’s deliberate action/not giving proper care or supervision

T/F: death is a standalone maltreatment, and you do not need to show what led to it

False

Critical Incident Rapid Response Team (CIRRT)

-led by department of health representative appointed by surgeon general, and is activated for severe child maltreatment or deaths to coordinate a quick assessment

-reviews are conducted to identify root causes, rapidly determine the need to change policies and practices related to child protection

in Florida, the leading cause of death for children aged 1-4 is….

drowning

Substance misuse maltreatment

extensive, abusive, and chronic use of a controlled substance or alcohol by a parent to the extent that the parent’s ability to provide supervision and care for the child has been or is likely to be severely compromised

-also applies when a parent exposes a child to a controlled substance or alcohol

effects of substance misuse/dependence on the family

• serves as a disinhibition for the parent

• lead to illegal activity and addiction

• can drain family resources

• may impair child caregiving behavior

• physical, emotional and sexual abuse

• choosing recreation over supervision

synthetic cannabinoids (spice and k2)

• designed to mimic the effects of THC

• lead to extreme mood swings, hallucinations, and erratic behavior

methamphetamine

-type or amphetamine that is manufactured and used illegally (meth, crystal meth, speed, crank, ice)

-extreme aggression/irritability, hallucinations, severe mood swings

MDA (sass or sassafras)

-a hallucinogenic amphetamine that shares similarities with MDMA (ecstasy)

-heightened sensory perception, increased energy and euphoria, jaw clenching, long-term cognitive impairment

Substance exposed newborn (SEN)

-healthcare providers must promptly inform child welfare agency

-develop a Plan of Safe Care (strategy that outlines the care and resources required to address needs of child and mom)

medication-assisted treatment (MAT)

combines medication with counseling to treat substance misuse disorders

-methadone, naltrexone, suboxone

urine analysis in child welfare

• why do we complete?: detect substance misuse, safety assessment, behavior correlation, treatment and rehabilitation, monitoring and compliance

• when do we complete?: initial assessment, randomized testing, post-incident, before key decisions

The Marchman Act

• legal framework in FL designed to aid individuals dealing with substance misuse and addiction

What options does the Marchman Act provide for people impacted by a family member’s substance misuse?

1. involuntary assessment and stabilization: treatment can be ordered up to 5 days

2. involuntary treatment: if further treatment needed after assessment, court can order up to 60 days of treatment

3. voluntary treatment: individuals can voluntarily seek treatment

4. case management: help navigate treatment and access resources

5. aftercare and support: counseling and support groups after

6. community resources: provide access to community-based resources

Intimate partner violence (IPV) threatens child

includes dynamics of establishing power, control, or coercion of one intimate partner over another along with actions that have caused or could cause harm to child

Power and control wheel: DV tactics

1. coercion and threats

2. intimidation

3. economic and academic abuse

4. emotional abuse

5. isolation

6. blame, minimization, and denial

7. children/loved ones as abusive mechanism

8. societal privilege

warning signs of lethality in DV

• history of violence

• access to weapons

• strangulation

• threats of homicide/suicide

• stalking behavior

• recent separation

• substance misuse

• unemployment/financial stress

when is the victim of DV most at risk for death?

when they have taken steps to leave

household violence threatens child

refers to situations in which household members engage in an violent behavior that demonstrates a wanton disregard for a child’s safety and/or could result in injury to child

-wanton disregard: a grave negligence in fulfilling the responsibility to care for a child

Special Conditions Referrals

do not meet the criteria for an investigation (there is no maltreatment involved), but require a response by department

what are the four categories of special conditions referrals?

1. Parent Needs Assistance (PNA): referrals from parents seeking help for themselves

2. child-on-child sexual abuse: sexual behavior by one child on another

3. foster care referral: reports concerning the care provided to a child placed outside their home

4. caregiver unavailable: caregiver hospitalized, incarcerated, dead