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Teach

The staff members you work with do their best every day to keep children safe. Suspecting child abuse or neglect can be the most difficult professional experience they encounter. It is an experience that can challenge them personally and professionally. Your role is to help staff learn the possible signs and behavioral indicators of child abuse and neglect. You can help them process information and support them as they report their suspicions.

To do this important work, we must be able to recognize when a child is in harm’s way. Look for the following signs from the Child Welfare Information Gateway fact sheet on What is Child Abuse and Neglect? Recognizing the Signs and Symptoms (U.S. Department of Health and Human Services).

The child:

• Shows sudden changes in behavior or school performance 
• Has not received help for physical or medical problems brought to the parents’ attention
• Has learning problems (or difficulty concentrating) that cannot be attributed to specific physical or psychological causes
• Is always watchful, as though preparing for something bad to happen 
• Lacks adult supervision 
• Is overly compliant, passive, or withdrawn 
• Comes to school or other activities early, stays late, and does not want to go home 
• Is reluctant to be around a particular person 
• Discloses maltreatment

The parent:

• Denies the existence of—or blames the child for— the child’s problems in school or at home 
• Asks teachers or other caregivers to use harsh physical discipline if the child misbehaves 
• Sees the child as entirely bad, worthless, or burdensome 
• Demands a level of physical or academic performance the child cannot achieve 
• Looks primarily to the child for care, attention, and satisfaction of the parent’s emotional needs 
• Shows little concern for the child

The parent and child:

• Touch or look at each other rarely 
• Consider their relationship entirely negative
• State consistently they do not like each other

It’s not always easy to recognize child abuse and neglect. Remember that any one of these signs by itself does not necessarily mean a child has been abused. Often a pattern or combination of behaviors will lead to the suspicion that a child is experiencing abuse or neglect to support your understanding. Watch this video to learn about the long-term effects of abuse and neglect for children and youth.

A Reasonable Suspicion of Child Abuse or Neglect

It is not uncommon for staff members to doubt themselves when they suspect child abuse or neglect. In many ways, this is human nature: we want to see the best in families and co-workers. Unfortunately, doubting oneself about suspicions of child abuse or neglect can be very dangerous. You must help staff members learn to recognize the signs that constitute a reasonable suspicion. You can also help them learn to follow their instincts. You can begin doing this by simply helping them understand the term suspicion. A suspicion is an unsubstantiated belief that something is wrong. It is an inkling or a feeling, based on observation or experience, that a child is being mistreated. Staff members do not need to prove that child abuse or neglect is occurring. They should not investigate. They do not even need to know who the suspected abuser is. If they think a child has been harmed or is in danger of being harmed, they have a reasonable suspicion of child abuse or neglect.

Your Family Advocacy Program can provide training and technical support around recognizing child abuse and neglect. The best trainings are often developed in collaboration between you and the FAP staff. Reach out to the FAP office on your installation. Learn about the resources they can provide. They are only a phone call away, and they can help you and staff members talk through what you have observed. They can help recognize whether or not a reasonable suspicion of child abuse or neglect has occurred.

Ask Questions and Open the Lines of Communication

All children get hurt occasionally: bumps, bruises, and scrapes can be signs of healthy exploration. Sometimes, more serious accidents happen as well: a child pulls a cup of hot tea down on themselves or a child is involved in a car accident. Sometimes a medical condition causes symptoms that mimic abuse. To be most effective at protecting children from child abuse and neglect, we must be able to differentiate between accidents and abuse. Conversations are a powerful tool for doing so. Whenever you or a staff member notice an injury or symptom in a child, ask the family member about it. This is a standard part of caregiving and shows that your program takes an interest in the child’s well-being. Here are some tips for asking questions:

• Ask open-ended questions. You might say, “Ouch. That looks like it hurts. What happened?”
• Show concern and empathy: “I bet that was pretty scary. How did it happen?”
• Make sure it’s an OK time to talk, and be prepared to get help if the family needs it. “Is it OK to ask you about Geri’s bruises? Do you have a minute?”
• Find out if there is anything else you should know about the injuries. “I’m glad you took them to the doctor. Is there anything we should do to make them comfortable during the day? Or is there anything they shouldn’t do?”

In most cases the family member will give you a clear and accurate account of what happened. For older toddlers, preschoolers, and school-age children, you should also ask the child what happened. You might suspect child abuse or neglect if:

• The child’s answer and the adult’s answers do not match or if two different adults give conflicting stories about how the injury happened. For example, a child has scratches all over her face. At drop-off, her dad says she got them from a child at a birthday party. At pick-up, her mom says she got them from the family cat.
• The story does not seem consistent with the child’s developmental level. For example, you might suspect abuse if a parent says a 4-month-old climbed out of a crib and got hurt.
• The story is not consistent with the injuries. For example, a child has burn marks on his hands that look almost like gloves—his hands were clearly submerged in something hot. His mother says the child accidentally grabbed a pot off the stove. Accidental burn injuries usually show some kind of splatter patterns as the child pulls away.

Understand and Discuss Age-Specific Risks:

Shaken Baby Syndrome

Shaken baby syndrome is a form of head trauma and brain injury. It can be caused by violently shaking, dropping, or throwing an infant. Most victims of shaken baby syndrome are under the age of 1, with the average age of victim being between 3 and 8 months, however it may be seen in children up to 5 years of age. When babies are shaken, their neck muscles are not strong enough to control their heads. This causes the brain to move back and forth inside the skull. The result is bleeding and bruising of the brain. The effects are even worse when the shaking ends with a sudden impact, as when a child is slammed into a crib or against a wall. If you think the child has been shaken, seek medical attention right away.

Look for the following symptoms of shaken baby syndrome. Remember, no one sign alone is definitive evidence of abuse. Look for a combination of the following:

• altered consciousness
• an inability to focus the eyes or track movement
• an inability to lift the head
• decreased alertness
• difficulty breathing
• extreme irritability
• lack of smiling or vocalizing
• lethargy, sleepiness
• pale or bluish skin
• poor feeding

Internet Predators and Cyber-Bullying

School-age children are growing up in a world of online social networks. They may have access to websites where they have “friends” they have never actually met. Staff members must be on the lookout for signs that a child is engaged in dangerous or inappropriate relationships online. You will learn more about this in the Safety lesson. Make sure that you and all staff members can monitor children’s Internet usage, and make sure they know never to meet a person they only know online. To keep children safe, make sure you and program staff:

• Can always see the monitors when children are on computers
• Check browser histories
• Install software that blocks questionable content
• Talk to school-age children about safe internet use

Remember that many school-age children have access to the internet at all times on smartphones or handheld devices. Help staff members talk to school-age children about safe phone use and texting. Discuss boundaries related to sharing images and content. Make sure children feel safe talking to an adult if (a) they receive inappropriate content from another child or an adult or (b) they are being asked to share inappropriate content or images of themselves. Also be aware of staff members’ phone use in the program: make sure staff members know appropriate boundaries for communication with children.

All staff must also be on the lookout for children who are being victimized online. This victimization can come from other children, but it can also come from adults. There have been several high-profile stories in the media of children being taunted, harassed, belittled, and insulted online. Sometimes, these stories come to light after the child dies by suicide. Many victims are under the age of 12. Observe for the signs of emotional abuse that you will read about later in the lesson.

Crushes and Predatory Relationships

School-age children may begin to show an interest in sex and romantic relationships. It’s not unusual for children to have “boyfriends” and “girlfriends.”  It’s also not unusual for school-age children to have crushes on teachers or school-age program staff. For LGBTQ youth, lack of safe spaces to discuss their identities and sexual development puts them at increased risk for exploitation and abuse (National Child Traumatic Stress Network, 2014).

As a Training & Curriculum Specialist, you must remain alert for these situations and handle them appropriately. Enforce your program’s Guidance and Touch Policy with all staff members. Teach staff members how to respond if an older child does something that makes them uncomfortable: sits on a staff members lap, squeezes in next to an adult on the couch, or grabs a staff members hand. Make sure staff members know to avoid being alone with a child. Make sure staff members know that they should never share images, videos, jokes, or content that are sexual or romantic in nature.

Remember that you and program staff are working with young children and pre-teens. The �Թ��� focused topic on Sexual Development and Behavior in Youth and Children can help you understand healthy development and sexual concerns. Although the child might have a crush, sexual activity or sexual touching is never consensual. If you suspect that a child is being sexually abused by a staff member, another adult, teen, or another child, you must make a report. You will learn about reporting procedures in the next lesson.

Model

Program Practices that Promote Recognition of Abuse and Neglect

• Get to know all of the children in your program and their families. In large programs, this can be challenging. It is critical that you make an effort, though. Take the time to greet families as they arrive in the mornings and afternoons at different programs. This will go a long way towards helping you learn families’ names and stories. Have conversations with families during special events, and be present in the family resource area of your program. Offer family education events, too. These are great ways to get to know small groups of families. You will be a much more effective resource for staff members if you know the children and families yourself. Talk to families every day. Learn children’s names.
• Be a resource on child development. Some changes in a child’s behavior can be startling for staff members—but are completely typical. For example, it’s not unusual for toddlers to have bruises all over their legs or on their heads. Falling is a part of learning to walk and run! Young children may be scared of certain adults as part of typical “stranger anxiety.” Pre-teens might be moody or occasionally say they hate their parents. Knowing these developmental stages can help you recognize when a child’s behavior goes beyond what is typically expected.
• Offer trainings in collaboration with your installation’s Family Advocacy Program on child abuse identification and reporting.
• Offer trainings in collaboration with your local Child Protective Services (CPS) agency on child abuse identification and reporting.
• Develop respectful communication skills. You will learn more about this in the Communication course. You will need these skills to communicate with staff members and families. If a staff member has a concern about a child, listen and help the staff member feel heard. You might say, “It sounds like you are concerned about Samantha. Tell me what you’ve noticed.” If you have a concern about a child, ask about it. Ask open-ended questions that focus on the child’s well-being. “Is it OK if I ask you about Jordan’s bruises?” or “I’ve noticed that Tasha hasn’t seemed like herself lately. Is everything OK?” If something doesn’t seem right, gather as much information as you can.
• Learn about the cultures of the children in your program. Some cultures have rituals or healing practices that might be mistaken for signs of abuse. Staff members might have questions, and you can help them find answers. When in doubt, though, encourage staff members to make a report. Child Protective Services or the Family Advocacy Program will decide whether abuse has occurred.
• Communicate the reporting procedures for your state or installation to all staff members. You will learn more about this in the next lesson.

Observe

There are signs often associated with particular types of child abuse and neglect. Download and print the attachment in the Apply section for a complete list. It is important to note, however, that these types of abuse are more typically found in combination than alone. A physically abused child, for example, is often emotionally abused as well, and a sexually abused child also may be neglected. Remember, there are two kinds of abuse to remain aware of: familial and institutional. The signs and behavioral indicators you see in children may be similar for each. Read the following scenarios. Then read what a Training & Curriculum Specialist might say or do to help a staff member recognize a reasonable suspicion of child abuse or neglect.

Remember, though, that it is not your job to investigate or interview a child or family. You and the staff members are mandated to report a suspicion of abuse or neglect. These suspicions are based on your observations and information freely provided by children, families, or staff. Interviewing the victim can actually damage the investigation. The “You Say” column is just meant as a helpful resource for those times when you must make a split-second decision about how to respond. In many cases, it is best just to report what you observed rather than to pry for more information. It is possible to bias a child’s testimony or to make a family defensive before an investigation begins. Always proceed with caution and remember that your role is to report rather than to investigate.

Observe for Signs of Abuse or Neglect in the Family

The following tables provide information about what you might see or hear in your programs. It also provides some guidance about what to say and do in these situations. The tables are interactive, so you can click through them to read all of the information. If you prefer, you can print a handout of this information at the end of the Learn section.

Observe Children for Signs of Abuse in the Program

Remember that every employee of the child development programs is a mandated reporter of child abuse and neglect. Each staff member has a legal and ethical obligation to report suspicions of child abuse and neglect and can face penalties for failing to do so. The first step in meeting their obligation is recognizing when a child has been harmed or is in imminent risk of harm. Learning to recognize the signs of abuse and neglect is equally important for you and the direct care staff members. Take time to make sure you know what to look for and how to help staff members spot the signs.