Child Welfare & The Mandated Reporter R[2]


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Comprehensive overview on the evolution of child welfare legislation with real life examples of child abuse, neglect and/or maltreament as well as an array of practical information for Mandated Reporters.

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Child Welfare & The Mandated Reporter R[2]

  1. 1. RCDS: Early Intervention & EnrichmentProgram Presents Child Abuse & Neglect: Prevention & The Role of The Mandated Reporter Facilitated by: Dawn Mastoridis, M.Ed., CAGS Executive Director, RCDS 1 About Your Speaker: Dawn Mastoridis In August of 2007, I joined The MENTOR Network as their State Director for the New York area. The MENTOR Network is a national human service organization that offers a wide range of community-based programs for at-risk adults & children. I serve as the Executive Director for Rockland Child Development Services (RCDS) which provides home, community & center- based Early Intervention services within the Bronx, Queens, Brooklyn & Manhattan as well as Rockland & Orange County. I have been a ‘Mandated Reporter’ for over 20 years. Early in my career, I served as an Outpatient Substance Abuse Therapist in Massachussetts working with families & individuals affected by alcohol or drug abuse. My history within the Early Intervention {EI} Program dates back to 1993 when I developed one of the first home/community based EI Programs to serve Brooklyn & Queens. However, I am most well-known for establishing & directing the EI Program for Personal-Touch Home Care from 1995 to 2006. Additionally, I have served as an Adjunct Instructor at Daemen College’s Special Education graduate program (TTI) based in Brooklyn. My credentials include a M.Ed. in Counseling & Psychological Services as well as a Certificate of Advanced Graduate Studies {CAGS} in Marriage & Family Therapy. As part of RCDS’ Community Outreach Program, I periodically facilitate workshops on a wide range of topics including but not limited to Child Abuse & Prevention. 2888-518-8716 Ext. 4111~ ~ 1
  2. 2. RCDS: Early Intervention & EnrichmentProgram Common Myths About Parenting or Caring For Children MYTH #1: Most people, especially women, instinctively know how to care for children Fact: FALSE. Caregiving skills are not innate or the same for most people. Research indicates parenting/caregiving skills are largely influenced by a person’s own childhood as well as their natural temperament, parental expectations, immediate resources and basic coping skills. MYTH #2: All children are ‘lovable’ & require the same basic caregiving skills. Fact: FALSE. While all children DESERVE & NEED love, there are many individual differences that can make it a big challenge for caregivers or parents. Caregiver or parenting skills that work with some children may be ineffective for others. Regardless of whether a child is typically developing or delayed; a child’s temperament, personality or behaviors may require much more time & energy to address than another child. MYTH #3: A ‘good’ parent must be highly involved or in control of their child’s life. Fact: FALSE. In recent years a new term called helicopter parents has been coined to describe parents who micromanage or are hyper-involved in the lives of their children. However, a recent study has concluded that having so-called "helicopter parents" was associated with children becoming dependent, neurotic and less open as well as a slew of personality traits that are generally thought of as undesirable. 3 Common Myths and Facts about Child Abuse & Neglect MYTH #1: Its only abuse if its violent. Fact: Physical abuse is just one type of child abuse. Neglect and emotional abuse can be just as damaging, and since they are more subtle, others are less likely to intervene. MYTH #2: Only “bad” people abuse their children. Fact: While its easy to say that only "bad people" abuse their children, its not always so black and white. Not all abusers are intentionally harming their children. Many have been victims of abuse themselves, and don’t know any other way to parent. Others may be struggling with mental health issues or a substance abuse problem. MYTH #3: Child abuse doesnt happen in “good” families. Fact: Child abuse doesnt only happen in poor families or bad neighborhoods. It crosses all racial, economic, and cultural lines. Sometimes, families who seem to have it all from the outside are hiding a different story behind closed doors. 4888-518-8716 Ext. 4111~ ~ 2
  3. 3. RCDS: Early Intervention & EnrichmentProgram Part I: The History of “Legalized” Child Protection 5 The History of Child Protection  In 1866, Henry Bergh, a philanthropist and diplomat, who recognized the inhumane treatment suffered by many “animals” in our society, founded the American Society for the Prevention of Cruelty to Animals (ASPCA) prompting the New York state legislators to pass the countrys first effective anti-cruelty to animals law.  The ASPCA is the oldest humane organization in America. 6888-518-8716 Ext. 4111~ ~ 3
  4. 4. RCDS: Early Intervention & EnrichmentProgram The History of Child Protection  Eight years later, a young girl was found tied to a bed like an animal, neglected and brutally beaten by her foster parents.  In 1874, animals were legally protected from inhumane treatment, children werent.  Child abuse and neglect was considered a family matter and there was no one to intervene on behalf of the child.  That is until a small group of concerned citizens in New York City came together in 1875--with the assistance of Henry Bergh-- to become the first organized child protective institution in the world-- The New York Society for the Prevention of Cruelty to Children (NYSPCC). 7 The History of Child Protection So let’s meet the little girl who started it all… 8888-518-8716 Ext. 4111~ ~ 4
  5. 5. RCDS: Early Intervention & EnrichmentProgram Meet Mary Ellen McCormack-Wilson at 10 years of age 9 We meet Mary Ellen by way of an excerpt from her testimony in a New York City courtroom in 1874. 10888-518-8716 Ext. 4111~ ~ 5
  6. 6. RCDS: Early Intervention & EnrichmentProgram We meet Mary Ellen by way of an excerpt from her testimony in a New York City courtroom in 1874.  My name is Mary Ellen McCormack. I dont know how old I am...  I have never had but one pair of shoes, but I cant recollect when that was. I have no shoes or stocking this winter...  I have never had on a particle of flannel.  My bed at night is only a piece of carpet, stretched on the floor underneath a window, and I sleep in my little undergarment, with a quilt over me. 11 We meet Mary Ellen by way of an excerpt from her testimony in a New York City courtroom in 1874.  I am never allowed to play with any children or have any company whatever.  Mamma has been in the habit of whipping and beating me almost every day.  She used to whip me with a twisted whip, a raw hide. The whip always left black and blue marks on my body.  I have now on my head two black and blue marks which were made by mamma with the whip, and a cut on the left side of my forehead which was made by a pair of scissors in mammas hand.  She struck me with the scissors and cut me. 12888-518-8716 Ext. 4111~ ~ 6
  7. 7. RCDS: Early Intervention & EnrichmentProgram We meet Mary Ellen by way of an excerpt from her testimony in a New York City courtroom in 1874.  I have no recollection of ever having been kissed, and have never been kissed by mamma.  I have never been taken on my mammas lap, or caressed or petted.  I have never dared to speak to anybody, because if I did I would get whipped.  Whenever mamma went out I was locked up in the bedroom...  I have no recollection of ever being in the street in my life. 13 We meet Mary Ellen by way of an excerpt from her testimony in a New York City courtroom in 1874.  After Mary Ellen told her story in court, her foster mother was prosecuted for assault and battery.  Mary Ellen was placed into a new home in upstate New York and grew up a normal child.  She became a favorite to all those who knew her.  At twenty-four she married and had two daughters of her own. She also adopted a third orphaned child.  Her daughters reported that Mary Ellen was always reluctant to speak of her past, but she did show them the scars of burns on her arms and the scissor scar was always noticeable on her face. 14888-518-8716 Ext. 4111~ ~ 7
  8. 8. RCDS: Early Intervention & EnrichmentProgram We meet Mary Ellen by way of an excerpt from her testimony in a New York City courtroom in 1874.  It was her pride and joy to be able to provide her own daughters with a happy childhood in contrast to her own.  Mary Ellen died in 1956, at the age of 92 15 The History of Child Protection  Thus ... the beginning of an American society to confront its inherent moral obligation to protect kids --- even from their parents. But, reporting abuse was not required; reports stemmed only from incidents which involved serious physical injury or death. 16888-518-8716 Ext. 4111~ ~ 8
  9. 9. RCDS: Early Intervention & EnrichmentProgram The History of Child Protection  And so it was, still in the late 1950s, what happened in the family was regarded as a very private manner; children were considered their parents chattel, until:  In 1962, Dr. Henry C. Kempe described "The Battered Child Syndrome" and urged physicians to report suspected child abuse. 17 The History of Child Protection  Eventually many states responded to their perceived moral and legal responsibility by making child abuse a criminal act during the late 1960s.  However, reporting child abuse was still not legally required. Consequently, most incidents of suspected child abuse remained behind closed doors and were neither acknowledged nor challenged. 18888-518-8716 Ext. 4111~ ~ 9
  10. 10. RCDS: Early Intervention & EnrichmentProgram The History of Child Protection  Finally in 1974, The United States Congress, in enacted the Child Abuse Prevention and Treatment Act (CAPTA), which provided federal funds - dedicated to prevent child abuse - for states that passed laws requiring certain professionals (law enforcement professionals, educators, and medical and mental health care professionals) to report suspected child maltreatment.  In short order, every state had mandatory reporting laws enacted in their legislatures. 19 The History of Child Protection Child Abuse Prevention and Treatment Act (CAPTA) of 1974 P.L. 93-247 Major Provisions of the Act • Provided assistance to States to develop child abuse and neglect identification and prevention programs • Authorized limited government research into child abuse prevention and treatment • Created the National Center on Child Abuse and Neglect (NCCAN) within the Department of Health, Education, and Welfare to: - Administer grant programs - Identify issues and areas needing special focus for new research and demonstration project activities - Serve as the focal point for the collection of information, improvement of programs, dissemination of materials, and information on best practices to States and localities • Created the National Clearinghouse on Child Abuse and Neglect Information • Established Basic State Grants and Demonstration Grants for training personnel and to support innovative programs aimed at preventing and treating child maltreatment * 20888-518-8716 Ext. 4111~ ~ 10
  11. 11. RCDS: Early Intervention & EnrichmentProgram The History of Child Protection 21 New York States Child Protective Services Act (1973) In order to protect children who are victims of abuse or maltreatment, New York, like most states, created a child protective system in statute with five fundamental components: 1. detection through third-party recognition of children in danger, including mandatory and voluntary reporting of suspected child abuse and maltreatment; 2. emergency protective custody of children in "imminent danger"; 3. State Central Register of reports of suspected child abuse and maltreatment; 4. child protective services (a) to verify reports, (b) to provide immediate protection of children and (c) to begin the process of helping families by providing rehabilitative and ameliorative services; 5. and, when necessary, court action - Family Court action to remove a child, remove the allegedly abusive or neglectful parent from the child’s residence, impose treatment and/or Criminal Court action (by referring the case to law enforcement) to prosecute the perpetrator. 22888-518-8716 Ext. 4111~ ~ 11
  12. 12. RCDS: Early Intervention & EnrichmentProgram 23 The Purpose of New York States Child Protective Laws • Abused and maltreated children in this State need an effective child protective service to prevent them from suffering further injury and impairment. • The purpose of the Child Protective Services Act and amendments is to encourage more complete reporting of child abuse and maltreatment. The law establishes a child protective service in each county of the State. Each child protective service is required to receive and investigate child abuse and maltreatment reports, to protect children from further abuse or maltreatment, and to provide rehabilitative services for the children, parents, and other family members involved. • The purpose of the Family Court Act’s child abuse and neglect provisions is to help safeguard the physical, mental, and emotional well-being of abused and neglected children by establishing civil procedures to protect them. The Family Court Act provides a due process for determining when the State, acting on behalf of the child, may intervene against the wishes of the parent or other person legally responsible for the child’s care so that the child’s needs are properly met. 24888-518-8716 Ext. 4111~ ~ 12
  13. 13. RCDS: Early Intervention & EnrichmentProgram Child Protection Act Law  The main child protection act is the federal National Child Protection Act of 1993, although many similar state acts have been enacted.  The purpose of the National Child Protection Act of 1993 is to encourage states to improve the quality of their criminal history and child abuse records.  The Act was passed in October 1993 and amended in the Crime Control Act of 1994. 25 Child Protection Act Law  Requires states to submit "child abuse crime information" to, or index such information in the national criminal history background system maintained by the FBI.  Provides that a state’s reporting all felonies and serious misdemeanors to the FBI will satisfy this requirement of the Act.  Mandates that the U.S. Attorney General establish timetables for each state’s criminal history records system to reach milestones for improvement and completeness. 26888-518-8716 Ext. 4111~ ~ 13
  14. 14. RCDS: Early Intervention & EnrichmentProgram Infant Safe Haven Law  Many State legislatures have enacted legislation to address infant abandonment and infanticide in response to a reported increase in the abandonment of infants.  Beginning in Texas in 1999, "Baby Moses laws" or infant safe haven laws have been enacted as an incentive for mothers in crisis to safely relinquish their babies to designated locations where the babies are protected and provided with medical care until a permanent home is found.  Safe haven laws generally allow the parent, or an agent of the parent, to remain anonymous and to be shielded from prosecution for abandonment or neglect in exchange for surrendering the baby to a safe haven.  To date, approximately 47 States and Puerto Rico have enacted safe haven legislation. The focus of these laws is protecting newborns.  In approximately 15 States, infants who are 72 hours old or younger may be relinquished to a designated safe haven.  Approximately 14 States and Puerto Rico accept infants up to 1 month old. Other States specify varying age limits in their statutes. 27 Infant Safe Haven Law Summary of State Laws New York  Infant’s Age Citation: Penal Code §§ 260.03; 260.15: A child who is not more than 5 days old may be relinquished.  Who May Relinquish the Infant Citation: Penal Code §§ 260.03; 260.15: The child may be relinquished by his or her parent.  Who May Receive the Infant Citation: Penal Code §§ 260.03; 260.15: The child may be left with an appropriate person at a suitable location.  Responsibilities of the Safe Haven Provider : This issue is not addressed in the statutes reviewed.  Immunity for the Provider: This issue is not addressed in the statutes reviewed.  Protection for Relinquishing Parent Citation: Penal Code §§ 260.03; 260.15: Relinquishment of the child to a safe haven is an affirmative defense to prosecution for abandonment or endangering the welfare of a child.  Effect on Parental Rights Citation: Soc. Serv. Law § 358-a: Reasonable efforts to reunify the child with his or her parent are not required when a court has determined the child was abandoned by the parent with an intent to wholly abandon such child. Adapted From: 28888-518-8716 Ext. 4111~ ~ 14
  15. 15. RCDS: Early Intervention & EnrichmentProgram Infant Safe Haven Law Parents who are unable to care for their newborn infants may anonymously and legally leave their infant at a safe place such as a hospital. Call: 866-505-SAFE (7233) 29 Part II: Documenting & Reporting Child Abuse or Neglect 30888-518-8716 Ext. 4111~ ~ 15
  16. 16. RCDS: Early Intervention & EnrichmentProgram The State Central Register (SCR) of Child Abuse and Maltreatment • The New York State Office of Children and Family Services (OFCS) maintains a statewide Central Register of Child Abuse and Maltreatment for reports made pursuant to the Child Protective Services Act. The Central Register, also know as the "Hotline," receives telephone calls and faxes alleging child abuse or maltreatment. • The Register screens out those calls and faxes which do not constitute abuse or neglect or are otherwise inappropriate for the Register. The Register creates a written report of the call and transmits it electronically to the local child protective service for investigation, monitors the provision of child protective services and is capable of immediately identifying the existence of prior child abuse or maltreatment reports. • The Central Register receives telephone calls alleging child abuse and maltreatment twenty-four hours a day, seven days a week. The calls come from two sources: persons who are required by law to report suspected cases of child abuse and maltreatment and voluntary reporters. • All voluntary reporters may use the statewide, toll free number to report suspected cases of child abuse or maltreatment. The statewide, toll free number is: 1-800-342-3720. • NYS MANDATED REPORTERS must call: 1-800-635-1522 31 New Guidelines for Mandated Reporters  Beginning October 1, 2007, those mandated reporters who work for a school, child care provider, foster care facility, residential care facility, hospital, medical institution or mental health facility, and who have direct knowledge of any allegation(s) of suspected child abuse or maltreatment, must personally make a report to the SCR.  Afterwards, that reporter should then notify the person in charge of the institution that a report has been made. The person in charge is then responsible for all subsequent internal action that must follow such a report.  This may include providing follow- up information to child protective services (CPS), for example, relevant information contained in the child’s educational record. 32888-518-8716 Ext. 4111~ ~ 16
  17. 17. RCDS: Early Intervention & EnrichmentProgram Reporting Suspected Abuse or Neglect FORM LDSS- 2221-A 33 Reporting Suspected Abuse or Neglect 34888-518-8716 Ext. 4111~ ~ 17
  18. 18. RCDS: Early Intervention & EnrichmentProgram Reporting Suspected Abuse or Neglect 35 Documentation Guidelines for Mandated Reporters ELEMENTS OF OBJECTIVE DOCUMENTATION ALWAYS Use concrete, descriptive language • Example: Dinner dishes were encrusted with old food. • Not: Poor hygiene was evident. Record evidence of the senses such as things seen, heard, smelled, tasted and touched • Example: Therapist observed Mrs. Jones hitting Jimmy several times with a belt, causing him to scream loudly. • Not: Mrs. Jones is an abusive parent. Use words with clear meanings and avoid value-laden terms • Example: Mr. Smith argued with the neighbor. • Not: Mr. Smith is belligerent. Fully identify persons, places, direct quotations and sources of information • Example: The client’s mother, Mrs. Wasson said “I can’t meet today.” • Not: It was noted that Mrs. Wasson refused to meet today Record facts, not an evaluation of the facts • Example: Sally missed her appointment three times last week. • Not: Sally was absent from treatment because she hates therapy. Clearly label your impressions and base them on observable information • Example: I believe that Mrs. Kent cannot care for her children because she failed to visit or contact them or me for over six (6) months. • Not: Mrs. Kent wants her children to remain in foster care. 36888-518-8716 Ext. 4111~ ~ 18
  19. 19. RCDS: Early Intervention & EnrichmentProgram Documentation Guidelines for Mandated Reporters IF you begin to develop concerns about a child’s welfare, Mandated Reporters, should begin keeping a comprehensive record even prior to placing a report:  Step 1: Record your concerns immediately. Always include the date and time of the incident.  Step 2: Document facts, not opinions. If a child has a bruise, for example, write down the color, location and size of the bruise. It is unnecessary to include your opinion about how you think it may have occurred.  Step 3: Write down what the caregiver told you about the incident or injury. Youll also want to include what the child, sibling or other witness said about the incident.  Step 4: Collect the names and contact information of everyone involved in the incident. While it is not your job to investigate a report, youll want to provide all of this information to the child services agency investigator or law enforcement officer to ensure that they can gather all of the necessary information and evidence.  Step 5: Sign, date and include the time of each entry.  Step 6: Report your concerns to the appropriate child protection agency and make sure you write down the name of the person you spoke with along with any suggestions or advice they offered. Write down the date and time of your formal report. 37 Documentation Guidelines for Mandated Reporters  Always document your concerns using pen and your own handwriting. If you need to change an entry, cross it out with a single line and initial it. It is important to stay away from using white out to correct entries.  Keep your written recordings in a safe place. The court system or investigator may request them during a formal investigation.  If you have any suspicion whatsoever that a child is being abused or neglected it is imperative that you call your local child protective services hot line immediately.  Documentation can be used as a means for supporting your concerns in the event of a formal child abuse investigation. It is imperative that you follow up any documented concerns with a formal report to your local child abuse and neglect hot line.  If the child is injured or the situation requires immediate attention, do not take the time to document your concerns. Call 911 38888-518-8716 Ext. 4111~ ~ 19
  20. 20. RCDS: Early Intervention & EnrichmentProgram Legal Protections for Mandated Reporters What Protection or Liability Do I Have? Source Confidentiality  The Social Service Law provides confidentiality for mandated reporters and all sources of child abuse and maltreatment reports. OCFS and local CPS are not permitted to release to the subject of the report any data that would identify the source of a report unless the source has given written permission to do so. Information regarding the source of the report may be shared with court officials, police, and district attorneys but only in certain circumstances. Immunity from Liability  If a mandated reporter makes a report with earnest concern for the welfare of a child, he or she is immune from any criminal or civil liability that might result. This is referred to a making a report in "good faith". Penalties for Failure to Report  Anyone who is mandated to report suspected child abuse or maltreatment - and fails to do so - could be charged with a Class A misdemeanor and subject to criminal penalties. Further, mandated reporters can be sued in a civil court for monetary damages for any harm caused by the mandated reporters failure to make the report to the SCR. 39 Part III: Defining Child Abuse & Neglect 40888-518-8716 Ext. 4111~ ~ 20
  21. 21. RCDS: Early Intervention & EnrichmentProgram Five Basic Types of Abuse:  Physical Abuse - Shaken Baby Syndrome (SBS)  Medical Abuse - Munchausen by Proxy Syndrome (MBPS)  Sexual Abuse  Child Neglect  Emotional Abuse 41 Physical Abuse 42888-518-8716 Ext. 4111~ ~ 21
  22. 22. RCDS: Early Intervention & EnrichmentProgram Physical Abuse 43 Physical Abuse; A Case Example Adapted From: 44888-518-8716 Ext. 4111~ ~ 22
  23. 23. RCDS: Early Intervention & EnrichmentProgram Physical Abuse: Shaken Baby Syndrome Shaken Baby Syndrome: Defined • Shaken Baby Syndrome (SBS) is caused by vigorous shaking of an infant or young child by the arms, legs, chest or shoulders. Long-term consequences can include learning disabilities, physical disabilities, partial or total blindness, hearing impairment, speech disabilities, cognitive disabilities, cerebral palsy, seizures, behavioral disorders and death. Scope of the Problem • More than one million children are severely abused annually. Shaken Baby Syndrome (SBS) is a leading cause of morbidity and mortality in infants. • In the United States, the annual incidence rate of Shaken Baby Syndrome is between 750 and 3,750. • One third of the victims of SBS survive with few or no consequences, one-third suffer permanent injury and one third die. • Parental behaviors, environmental factors and child characteristics all may contribute to a shaking event Adapted From: 45 Physical Abuse: Shaken Baby Syndrome Adapted From: 46888-518-8716 Ext. 4111~ ~ 23
  24. 24. RCDS: Early Intervention & EnrichmentProgram Physical Abuse: Shaken Baby Syndrome 47 Physical Abuse: Shaken Baby Syndrome Adapted From: 48888-518-8716 Ext. 4111~ ~ 24
  25. 25. RCDS: Early Intervention & EnrichmentProgram Physical Abuse: Shaken Baby Syndrome Adapted From: 49 Physical Abuse: Shaken Baby Syndrome (A) This computerized tomography (CT) scan of the brain, obtained immediately following a shaking event, shows significant cerebral edema. Due to brain swelling, the gray and white matter of the brain are unable to be differentiated. The reddened areas signify fresh blood between the brain hemispheres. (B) shows the same brain, scanned 3 months after the shaking event. The dark area shows areas of brain loss. The child did not survive. Reprinted with permission from Lauridson J, Levin A, Parrish R, Wicks A. 2002. Shaken Baby Syndrome: A Visual Overview. (Version 2.0) [Animated CD ROM], Ogden, Utah: The National Center on Shaken Baby Syndrome. 50888-518-8716 Ext. 4111~ ~ 25
  26. 26. RCDS: Early Intervention & EnrichmentProgram Physical Abuse: Shaken Baby Syndrome Adapted From: 51 Physical Abuse: Shaken Baby Syndrome Figure 5. The number of hours normal infants spent crying in the first 14 weeks of life. Note the peak at 6 weeks of age despite the wide range of distribution for all infants. Reprinted with permission from The National Center on Shaken Baby Syndrome, & Barr, R. It is here…The Period of Purple Crying [Brochure]; The National Center on Shaken Baby Syndrome, Ogden, Utah; 2002. 52888-518-8716 Ext. 4111~ ~ 26
  27. 27. RCDS: Early Intervention & EnrichmentProgram Physical Abuse: Shaken Baby Syndrome Figure 6. This graph illustrates the relationship between early infant crying and the timing of Shaken Baby Syndrome. The incidence of shaken baby syndrome peaks approximately 1month after the peak of early infant crying. Reprinted with permission from Barr, R.© Curves of early infant crying and SBS incidence. Proceedings of the Fourth National Conference on Shaken Baby Syndrome; 2002 Sept 12-15; Salt Lake City, Utah. 53 Physical Abuse: Shaken Baby Syndrome Adapted From: 54888-518-8716 Ext. 4111~ ~ 27
  28. 28. RCDS: Early Intervention & EnrichmentProgram Physical Abuse: Shaken Baby Syndrome Adapted From: 55 Physical Abuse: Shaken Baby Syndrome The Bottom Line: 56888-518-8716 Ext. 4111~ ~ 28
  29. 29. RCDS: Early Intervention & EnrichmentProgram Medical Abuse Medical child abuse occurs when a caregiver fails to ensure that the child receives the medical treatment that is necessary to ensure their health. This may include: •failure to ensure the child is up-to-date on immunizations; •failure to enroll the child in mental health counseling if necessary for their mental well- being, and; •even not ensuring a child takes medicine that is prescribed for their health; •fabricating or creating an illness in a child through the manipulation of medications or by intentionally sabotaging treatment efforts. Adapted From: 57 Medical Abuse: Munchausen By Proxy Syndrome Munchausen by Proxy Syndrome (MBPS) is a relatively uncommon condition that involves the exaggeration or fabrication of illnesses or symptoms by a primary caretaker. One of the most harmful forms of child abuse, MBPS was named after Baron von Munchausen, an 18th-century German dignitary known for telling outlandish stories. About MBPS • In MBPS, an individual — usually a mother — deliberately makes another person (most often his or her own preschool child) sick or convinces others that the person is sick. • The parent or caregiver misleads others into thinking that the child has medical problems by lying and reporting fictitious episodes. • He or she may exaggerate, fabricate, or induce symptoms. • As a result, doctors usually order tests, try different types of medications, and may even hospitalize the child or perform surgery to determine the cause. Adapted From: 58888-518-8716 Ext. 4111~ ~ 29
  30. 30. RCDS: Early Intervention & EnrichmentProgram Medical Abuse: Munchausen By Proxy Syndrome Reported Cases • Children who are subject to MBPS are typically preschool age, although there have been reported cases in kids up to 16 years old, and there are equal numbers of boys and girls. About 98% of the perpetrators are female. Diagnosing MBPS Diagnosis is very difficult, but would involve some of the following: • a child who has multiple medical problems that dont respond to treatment or that follow a persistent and puzzling course physical or laboratory findings that are highly unusual, dont correspond with the childs medical history, or are physically or clinically impossible short-term symptoms that tend to stop when the perpetrator isnt around; • a parent or caregiver who isnt reassured by "good news" when test results find no medical problems, but continues to believe that the child is ill; • a parent or caregiver who appears to be medically knowledgeable or fascinated with medical details or appears to enjoy the hospital environment; • a parent or caregiver whos unusually calm in the face of serious difficulties with the childs health; • a parent or caregiver whos highly supportive and encouraging of the doctor, or one who is angry and demands further intervention, more procedures, second opinions, or transfers to more sophisticated facilities Adapted From: 59 Medical Abuse: Munchausen By Proxy Syndrome What Happens to the Child? • In the most severe instances, parents or caregivers with MBPS may go to great lengths to make their children sick. When cameras were placed in some childrens hospital rooms, some perpetrators were filmed switching medications, injecting kids with urine to cause an infection, or placing drops of blood in urine specimens. • According to experts, common conditions and symptoms that are created or faked by parents or caregivers with MBP include: failure to thrive, allergies, asthma, vomiting, diarrhea, seizures, and infections. • The long-term prognosis for these children depends on the degree of damage created by the perpetrator and the amount of time it takes to recognize and diagnose MBP. Some extreme cases have been reported in which children developed destructive skeletal changes, limps, mental retardation, brain damage, and blindness from symptoms caused by the parent or caregiver. Often, these children require multiple surgeries, each with the risk for future medical problems. Adapted From: 60888-518-8716 Ext. 4111~ ~ 30
  31. 31. RCDS: Early Intervention & EnrichmentProgram Medical Abuse: Munchausen By Proxy Syndrome Getting Help for the Child If Munchausen by proxy syndrome is suspected, health care providers are required by law to report their concerns. However, after a parent or caregiver is charged, the childs symptoms may increase as the person who is accused attempts to prove the presence of the illness. If the parent or caregiver repeatedly denies the charges, the child should be removed from the home and legal action should be taken on the childs behalf. In some cases, the parent or caregiver may deny the charges and move to another location, only to continue the behavior. Even if the child is returned to the perpetrators custody while protective services are still involved, the child may continue to be a victim of abuse. For these reasons, its always advised that these cases be resolved quickly. Getting Help for the Parent or Caregiver Most often, abusive Munchausen by Proxy cases are resolved in one of three ways: • the perpetrator is apprehended • the perpetrator moves on to a younger child when the original victim gets old enough to "tell" • the child dies Adapted From: 61 Medical Abuse: Munchausen By Proxy Syndrome Adapted From: 62888-518-8716 Ext. 4111~ ~ 31
  32. 32. RCDS: Early Intervention & EnrichmentProgram Medical Abuse: Munchausen By Proxy Syndrome 63 Medical Abuse: Munchausen By Proxy Syndrome 64888-518-8716 Ext. 4111~ ~ 32
  33. 33. RCDS: Early Intervention & EnrichmentProgram Sexual Abuse 65 Sexual Abuse Man Sexually Abuses Toddler, Transports Kiddie Porn Tuesday, June 22, 2010 Adapted from: Paul C. Marlowe, 21, of Chesterfield County, Virginia, was sentenced to close to 18 years (210 months) in federal prison on Friday for transporting child pornography, a sentence that was enhanced because of Marlowe’s pattern of sexually abusing children and minors as young as 2 years old. “Every image in a child pornography case represents someone abusing a child,” said U.S. Attorney Neil MacBride. “These are not just photos, and this case makes clear that those who view these images may engage in abuse themselves. My office aggressively pursues these cases to stop the abuse and take these predators off our streets.” On January 20, 2010, Marlowe pled to two counts of transportation of child pornography. According to court documents in the case — obtained by the National Association of Chiefs of Police – Marlowe was identified by law enforcement officers during an undercover investigation of individuals trading images of child sexual abuse over the Internet. During their investigation, agents executed a search warrant at Marlowe’s residence where they seized a computer. A subsequent forensic examination revealed e-mails sent to different individuals from Marlowe’s AOL e-mail account with attachments containing numerous images of child pornography, as well as dozens of additional images and videos of child sexual abuse saved on the computer. Marlowe later admitted to agents to sending the e-mails. During interviews conducted during the course of the investigation, Marlowe also admitted to engaging in sexually explicit conduct with six children ranging in age from 2 to 14 years old. The case was investigated by the Federal Bureau of Investigation and the Virginia State Police. Special Assistant United States Attorneys Gene Fishel and Tommy Johnstone of the Virginia Attorney General’s Office prosecuted the case on behalf of the United States 66888-518-8716 Ext. 4111~ ~ 33
  34. 34. RCDS: Early Intervention & EnrichmentProgram Neglect & Maltreatment 67 Neglect & Maltreatment 68888-518-8716 Ext. 4111~ ~ 34
  35. 35. RCDS: Early Intervention & EnrichmentProgram Neglect & Maltreatment Adapted From: 69 Neglect & Maltreatment June 21, 2010 12:53 PM Boy, 10, Found Hiding Under Sink from Fla. Parents Accused of Torture; Cops Say Child Was Captive PORT CHARLOTTE, Fla. (CBS/WTEV) Parents of a 10-year-old Florida boy are charged with child abuse after police found the boy, who was reported missing, under a bathroom sink, according to CBS affiliate WTEV. The Charlotte County Sheriffs Office said Thomas Anthony Boone, 38, and Kimberly Sue Boone, 39, each face three counts of aggravated child abuse for intentionally torturing, cruelly punishing and unlawfully holding the child captive, reported ABCs WZVN. Charlotte County police began a search around 11 a.m. Saturday, after Thomas called the Sheriffs office to report the boy missing. Five hours later with the help of search dogs and helicopter units, authorities found the malnourished boy reeking of urine under the master bedroom sink. The boy told investigators that he escaped from his bedroom in search of food, then hid from his parents under the sink, said WZVN. Investigators told WTEV that the couple held the boy captive in his bedroom where authorities said he was forced to sleep on a urine-drenched bed and suffered Thomas Boone (left); Kimberly Boone (right) malicious punishment. According to WTEV, he was only allowed to leave for school or (Charlotte County Sheriffs Office) in the event that the family went away. Thomas and Kimberly Boone were released after each posting each $15,000 bond. 70888-518-8716 Ext. 4111~ ~ 35
  36. 36. RCDS: Early Intervention & EnrichmentProgram Frequently Asked Questions New York State: Office of Children & Family Services (OCFS) At what age is it okay to leave my children home alone?  OCFS is often asked questions regarding the appropriate age to leave a child alone, or what age is appropriate to allow a child to begin babysitting. There are no straightforward answers to these questions. All children develop at their own rate, and with their own special needs and abilities. Some children are responsible, intelligent, and independent enough to be left alone at 12 or 13 years of age. Likewise, there are some teenagers who are too irresponsible or who have special needs that limit their ability to be safe if they are left alone.  Parents and guardians need to make intelligent, reasoned decisions regarding these matters 71 Frequently Asked Questions New York State: Office of Children & Family Services (OCFS) Below there are some items for these decision-makers to consider before leaving a child alone. Be aware, this is just the beginning of issues to consider. It is not an all-inclusive checklist to guarantee intelligent and reasoned decision-making:  Consider the child: How mature is the child? How comfortable is the child with the circumstances? What has the child done in the past to show you he/she is able to take on this kind of responsibility?  Consider the child’s knowledge and ability: Does the child know how and when to contact emergency help? Is the child able to prepare food for him/herself? Are there hazards to the child in the environment such as accessible knives, power tools, a stove or oven?  Consider the circumstances: Where will the child be when left alone? How long is the child to be alone? 72888-518-8716 Ext. 4111~ ~ 36
  37. 37. RCDS: Early Intervention & EnrichmentProgram Part IV: Abuse Vs. Discipline & Parenting Styles 73 Abuse Vs. Discipline Adapted From: Abuse Discipline » Demonstrates anger and hostility. » Demonstrates love and affection. » Make child listen. » Teach child right from wrong. » Teach child that decisions are at the whim of the » Teach child to make healthy choices for him/herself caregiver. and prepare child for eventual independence. » Caregiver has all the power; child is given no » Based on a balance of power and mutual respect. respect. » Involves humiliation. » Does not involve humiliation. » Requires submission. » Does not require submission. 74888-518-8716 Ext. 4111~ ~ 37
  38. 38. RCDS: Early Intervention & EnrichmentProgram Abuse Vs. Discipline Adapted From: FACT: 94% of parents of toddlers reported using corporal punishment in the previous 12 months; 35% hit infants (Strauss, 2000, pp. 1109-11141). FACT: In an American study, 28.4% of parents of two to four-year-olds and 28% of five to eight-year-olds reported using an object to spank the bottoms of their children (Gallup Survey). Thus more than one in four parents admit to using an object to hit their children in the name of discipline (Gershoff, 2002, p. 602-6112). * NOTE: In the all 50 states, parents are legally allowed to spank their children. But in 29 states its illegal for a teacher to practice corporal punishment, including spanking. In January, 2004, the Supreme Court of Canada upheld Section 43 of the Criminal Code, stating parents had the right to spank their children without fear of being charged with a criminal offence. But this spanking law has some new restrictions. The law now states that spanking is permitted with children between the ages of 2 years and 12 years, that the use of weapons like belts and paddles are prohibited, that strikes to the face and head are also prohibited, and that only reasonable force can be administered. When discussing abuse and discipline, some would argue that any physical force constitutes abuse, where others maintain that spanking falls under the category of reasonable discipline. While it is not suggested that others TELL parents exactly how to discipline their children, it is strongly urged you help parents to make an informed decision by looking into alternative forms of discipline. 75 Abuse Vs. Discipline Adapted From: parents-alternatives-to-spanking Effective Discipline Techniques for Parents: Alternatives to Spanking Discipline vs. Punishment: • Discipline is defined as a positive method of teaching a child right from wrong. Punishment is a form of discipline. • Punishment may be physical--as in spanking, or psychological--as in verbal disapproval, isolation or loss of privileges. In some respects, punishment represents one end of a very broad spectrum of discipline techniques. • Discipline is a tool to help children learn self- control and take responsibility for their own behavior. Children who are raised in a way that stresses positive discipline will understand their own behavior better, show independence, and respect themselves and others. • When punishment is the basis for discipline, the person who punishes the child becomes responsible for the childs behavior. 76888-518-8716 Ext. 4111~ ~ 38
  39. 39. RCDS: Early Intervention & EnrichmentProgram Abuse Vs. Discipline Adapted From: techniques-for-parents-alternatives-to-spanking Effective Discipline Techniques for Parents: Alternatives to Spanking Alternatives to Physical Discipline: • Role Modeling. Most children learn behaviors by observing their parents’ actions. Parents, therefore, must model the ways they want their children to behave. Remember that if a parent often yells, screams, or hits, the child will likely do the same. • Setting Rules. Rules should be reasonable, fair, realistic and explained to child(ren) along with the consequences of not following them. A minimum set of rules should be established with attention given to the child’s age and developmental level. • Appropriate consequences allow a child to redeem him/herself and relate to the misbehavior. A child should be allowed to negotiate what the consequence will be; thus building self-esteem and cooperation skills. Children may feel less resentful and angry if they are allowed to help decide the consequence of their negative behavior. • Encourage and Reward Good Behavior. When children are behaving appropriately, tell them so! Children can be rewarded through tangible objects, privileges, increased responsibility and verbal praise. 77 Abuse Vs. Discipline Adapted From: parents-alternatives-to-spanking Effective Discipline Techniques for Parents: Alternatives to Spanking Alternatives to Physical Discipline: • Creating Charts. Using charts to monitor and reward behavior is an interactive way for a child to learn appropriate behavior. A child’s “progress chart” may create improved cooperation and increased self-esteem. Charts should be simple and used for one behavior at a time with a designated time frame in mind. • Time-Out. Time-out involves removing a child from a situation following a negative behavior as a means to calm down, establish control, end inappropriate behavior, and reenter the situation in a positive state. Effective time-outs include an explanation of what the inappropriate behavior is and why the time- out is needed. The child should be told how long the time-out will last and when it will begin. The amount of time should be determined based on the child’s age and developmental level. 78888-518-8716 Ext. 4111~ ~ 39
  40. 40. RCDS: Early Intervention & EnrichmentProgram Abuse Vs. Discipline Adapted From: 79 Parenting Styles In 1966, Diana Baumrind proposed a popular model of parenting styles. "Baumrind believes that parents should be neither punitive nor aloof.“ Rather, they should develop rules for their children and be affectionate with them. In her research she identified three main parenting styles in early child development: authoritative, authoritarian, and permissive. Baumrinds Model Two key factors emerge in parenting style factor analysis: • Demandingness: This relates to the demands the parents make on the child to be part of the family, their expectations for mature behavior, the discipline and supervision they provide, and their willingness to confront behavioral problems. • Responsiveness: This relates to fostering individuality, self-assertion, and regulation, as well as being responsive to special needs and demands. Maccoby & Martin expanded the styles to four: authoritative, authoritarian, indulgent and neglectful. These four styles of parenting involve combinations of acceptance and responsiveness on the one hand and demand and control on the other. These parenting styles are meant to describe normal variations in parenting, not deviant parenting, such as might be observed in abusive homes. Most parents do not fall neatly in one category, but fall in the middle, showing characteristics of more than one style Adapted From: 80888-518-8716 Ext. 4111~ ~ 40