Child Abuse/Neglect

What does Child abuse mean?

Abuse or neglect of a child” defined.

• “Abuse or neglect of a child” means, except as otherwise provided in subsection 2*:

  • (a) Physical or mental injury of a nonaccidental nature;

  • (b) Sexual abuse or sexual exploitation; or

  • (c) Negligent treatment or maltreatment as set forth in NRS 432B.140,

• of a child caused or allowed by a person responsible for the welfare of the child under circumstances which indicate that the child’s health or welfare is harmed or threatened with harm.

* Safe Haven Law; refusal of treatment or alternative treatment in good faith

1. Define Child Sex. Abuse

2. Important Note?

Child Sexual Abuse

• Definition:

  • any sexual behavior or action toward a child that is unwanted or exploitative

• Important note:

  • Sexual abuse does not have to involve direct touching or contact by the perpetrator.

1. MC Physical finding?

2. Associated violence?

MC Physical finding:

• Normal Exam

  • even with vaginal penetration, the hymen may be intact

Associated violence:

• Common in older children

  • (likely a consequence of resistance)

1. What requires a report?

2. Who has to report?

3. To whom is a report made?

4. What must be included?

5. Will I have to go to court?

6. What if I’m wrong?

7. What if you don’t?

What requires a report?

• reasonable cause to believe that a child has been abused or neglected

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Who has to report?

• Medical health care professionals and adjacent fields

• Coroner

• Religious people

  • (unless catholic; then can’t report if the offender confessed during confession)

• Employees of Schools

• Anyone working in a facility/establishment that provide care for children

• Law people

• Foster homes

• People who help children (CPS) or Youth Shelter

• Insurance people

• Anybody can report

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To whom is a report made?

• to child welfare services agencies or to law enforcement agency

• Make such a report as soon as reasonably practicable but not later than 24 hours

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What must be included?

• The name, address, age and sex of the child;

• The name and address of child’s parents or other person responsible for care of child;

• The nature and extent of the abuse or neglect of the child

• Any evidence of previously known or suspected

  • (1) Abuse or neglect of the child or the child’s siblings; or

  • (2) Effects of prenatal illegal substance abuse on or evidence of withdrawal symptoms

•  The name, address and relationship of abuser

• Any other necessary information

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Will I have to go to court?

• Maybe

• Good documentation is the key

  • Can keep you from having to go to court,

  • Makes testifying much easier if you do have to go, and

  • Is more likely to result in an appropriate legal determination.

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What if I’m wrong?

• immunity from civil or criminal liability extends to every person who in good faith:

• Except in professional negligence

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What if you don’t?

• First violation: misdemeanor

• Subsequent: gross misdemeanor

What is the triad?

The Triad

Suspicion for nonaccidental injury should come if there is a mismatch among any of these three components:

• The Child

• The Story

• The Injury

How to perform:

• History

• Examination

Where to get growth/milestone charts

History

• Document in detail

  • Use the caregiver’s words, in quotes when possible

  • Clear communication for healthcare workers

  • Reveals a changing story - a red flag

  • Support in court when necessary

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Examination

•  Examine completely

  • Extent of injury

  • Associated injuries

  • Old injuries

• Document in detail

  • Measurements

  • Clear language

  • Photos - with ruler and color standard if possible

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Where to get growth/dev milestones:

• Growth charts

• Denver II Developmental Screening

• Harriet Lane Handbook

• Bright Futures Initiative