New York Child Abuse Identification and
Reporting
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Course Details
In order to receive contact hours for this course, the learner must successfully complete
the course exam with a 70% or better.
The Planners and Authors of this course have declared no conflicts of interest related to
this educational activity.
Course Expiration Date:
Course No: NY-ABUSE-21
Contact Hours: 2.0
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Author: Adrianne E. Avillion, D Ed, RN
Subject Area: Pediatrics
Description:
Child abuse impacts children from every socioeconomic group, culture, and ethnicity.
According to the American Society for the Positive Care of Children approximately five
children die from child abuse every day in the United States. In 2019, an estimated 67,269
children were victims of child abuse in New York. Healthcare professionals have a grave
responsibility to recognize and report child abuse and maltreatment. This course is
designed to fulfill requirements for education in the identification and reporting of child
abuse, child maltreatment, and child neglect for mandated reporters in New York.
Objectives
1. Define terms relevant to child abuse according to the state of New York.
2. Discuss the incidence and prevalence of child abuse.
3. Identify risk factors for child abuse and maltreatment.
4. Describe the various types of child abuse and maltreatment and the
consequences
5. Explain how to report child abuse and maltreatment in New York state.
6. Describe strategies to prevent child abuse and maltreatment.
Introduction
Child abuse impacts children from every socioeconomic group, culture, and ethnicity.
According to the American Society for the Positive Care of Children approximately five
children die from child abuse every day in the United States (Statista, 2020). State and
federal governments have responsibilities to enact legislation for the protection of
children. Similarly, healthcare professionals have a responsibility to recognize and
report suspected child abuse and maltreatment.
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Definition of Terms
The World Health Organization (WHO, 2020) defines child maltreatment as “the abuse
and neglect that occurs to children under 18 years of age. It includes all types of
physical and/or emotional ill-treatment, sexual abuse, neglect, negligence, and
commercial or other exploitation, which results in actual or potential harm to the child’s
health, survival, development, or dignity in the context of a relationship of responsibility,
trust, or power.”
The maltreatment of children is a global problem that has “serious, life-long
consequences. International studies show that nearly three in four children aged two to
four years old regularly suffer physical punishment and/or psychological violence at the
hands of parents and caregivers. One in five women and one in 13 men report having
been sexually abused as a child” (WHO, 2020).
In the United States (U.S.), child abuse and maltreatment are widespread, serious
problems (Centers for Disease Control and Prevention (CDC), 2021c). As part of the
efforts to reduce child abuse, the state of New York has mandated that healthcare
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professionals receive education and training regarding child abuse and maltreatment,
recognition, reporting, and prevention efforts.
New York State Definitions
The following definitions are summaries of New York state definitions according to The
Family Court Act of the state of New York (New York State Senate, multiple dates; Rizvi
et al., 2021).

Abused child –
o
A child whose parent or another person legally
responsible for his or her care inflicts or allows to be
inflicted upon such child physical injury by nonaccidental means, which causes or creates a
substantial risk of death, serious or protracted
disfigurement, protracted impairment of physical or
emotional health, or protracted loss or impairment of
the function of any bodily organ; or
o
A child whose parent or another person legally
responsible for his or her care creates or allows to be
created a substantial risk of physical injury to such
child by non-accidental means, which would be likely
to cause death, serious or protracted disfigurement,
protracted impairment of physical or emotional health,
or protracted loss or impairment of the function of any
bodily organ; or
o
A child whose parent or another person legally
responsible for his or her care commits, or allows to
be committed an offense against such child defined in
article 130 of the Penal Law; (B) allows, permits, or
encourages such child to engage in any act described
in sections 230.25, 230.30, 230.32, and 230.34-a of
the Penal Law; (C) commits any of the acts described
in sections 255.25, 255.26, and 255.27 of the Penal
Law; (D) allows such child to engage in acts or
conduct described in article 263 of the Penal Law; or
(E) permits or encourages such child to engage in any
act or commits or allows to be committed against
such child any offense that would render such child
either a victim of sex trafficking or a victim of severe
forms of trafficking in persons pursuant to 22 U.S.C.
7102 as enacted by public law 106-386 or any
successor federal statute; (F) provided, however, that
(1) the corroboration requirements contained in the
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Penal Law and (2) the age requirement for the
application of article 263 of such law shall not apply to
proceedings under this article.

Child – Any person or persons less than 18 years of age.

Respondent – Any parent or other person legally responsible for a child’s
care who is alleged to have abused or neglected the child.

Neglected child or maltreated child – A child whose physical mental, or
emotional condition has been impaired or is in imminent danger of
becoming impaired as a result of the failure of his parent or other person
legally responsible for his care to exercise a minimum degree of care
including the:
o
Provision of adequate food, clothing, shelter, medical
care or education in accordance with the law;
o
Provision of proper supervision or guardianship. The
lack thereof can be characterized by unreasonably
inflicting harm or allowing harm to be inflicted, or a
substantial risk thereof, including infliction of
excessive corporal punishment; or by misusing a drug
or drugs, alcohol, or other acts of a similarly serious
nature requiring the aid of the court.
o
Maltreatment and neglect are often used
interchangeably, but they actually have different
definitions. Maltreatment includes acts of omission
and commission, whereas neglect only includes acts
of omission. Maltreatment includes neglect, but
neglect does not include maltreatment.

Person legally responsible – The child’s custodian, guardian, or any other
person responsible for the child’s care at the relevant time.

Impairment of emotional health/condition – A state of substantially
diminished psychological or intellectual functioning in relation to, but not
limited to, such factors as failure to thrive, control of aggressive or selfdestructive impulses, ability to think and reason, or acting out or
misbehavior, including incorrigibility, ungovernability, or habitual truancy,
provided, however, that such impairment must be clearly attributable to
the unwillingness or inability of the respondent

Child protective agency – The child protective service of the appropriate
local department of social services or such other agencies with whom the
local department has arranged for the provision of child protective
services.

Parent – A person who is recognized under the laws of the state of New
York to be the child’s legal guardian.
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
Relative – Any person who is related to the child by blood, marriage, or
adoption, and who is not a parent, putative parent, or relative of a putative
parent of the child.

Suitable person – Any person who plays or has played a significant
positive role in the child’s life or the life of the child’s family.

Person with a handicapping condition – Indicates a person who is 18
years or older who is in residential care in one of the following facilities:
o
New York State School for the Blind.
o
New York School for the Deaf.
o
A private residential school that has been designed
for special education.
o
A special act school district or a state-supported
school for the deaf or blind with a residential
component.
Incidence and Prevalence of Child Abuse
and Neglect
International Data
Child maltreatment is a complex issue. It can be difficult to obtain reliable data on the
subject because current estimates vary significantly depending on the country being
studied and the research method used (WHO, 2020).
Estimates depend on (WHO, 2020):

Definitions of child maltreatment used.

The type of child maltreatment studied.
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
The coverage and quality of official statistics.

The coverage and quality of surveys that request self-reports from victims,
parents, and caregivers.
Using available data, the WHO has assembled the following statistics (WHO, 2020).

International studies show that almost three in four children aged two to
four years old suffer physical punishment and/or psychological violence
committed by parents and caregivers. One in five women and one in 13
men report having been sexually abused as a child.

Girls are especially vulnerable to sexual violence, exploitation and abuse
by combatants, security forces, and even members of their own
communities in settings of armed conflict and refugee settings.

120 million girls and young women less than 20 years of age have had to
deal with some type of forced sexual contact.
United States Data
The United States (U.S.) has one of the poorest records in helping children reach their
full potential. Save the Children (2020), in its 2020 Global Report, scored 180 countries
using a maximum rating of 1000. Scoring is based on a country’s efforts to save
children from poverty discrimination, and neglect—ultimately trying to access how well
children are meeting their full potential.
Save the Children (2020) defines full potential of childhood as “healthy children in
school and at play, growing strong and confident with the love and encouragement of
their family and an extended community of caring adults, gradually taking on the
responsibilities of adulthood, free from fear, safe from violence, and protected from
abuse and exploitation.” Unfortunately, many children throughout the world do not have
such a positive experience.
Singapore rates first in 2020 with a score of 989 out of 1,000. Eight countries in Western
Europe scored in the top 10. These countries have very high scores for children’s
health, education, and protection. Nigeria ranks last among countries that were
surveyed with a score of 375 out of 1,000. The United States scores behind most
industrialized nations at 43, with a score of 942 out of 1,000 (Save the Children, 2020).
According to the American Society for the Positive Care of Children (SPCC) (2021):

4.3 million child maltreatment referral reports were received.

Child abuse reports involved 7.8 million children.

91.7% of victims are maltreated by one or both parents.
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
Only 3.3 million children received prevention and post-response services.

146,706 children received foster care services.

411,969 victims (60.8%) are neglected.

72,814 victims (10.7%)

47,124 victims (7%) are sexually abused.

15,605 victims (2.3%) are psychologically maltreated.

Highest rate of child abuse is in children under age one (26.7 per 1000).

Annual estimate: 1,770 children from abuse and neglect in 2018.

Almost five children die every day from child abuse.

70.6% of all child fatalities were younger than three years of age.

80.3% of child fatalities involve at least one parent.

Of the children who died, 72.8% suffered neglect.

Of the children who died, 46.1% suffered physical abuse.

46.6% of children who die from child abuse are under one year.

Boys had a higher child fatality rate than girls (2.87 boys and 2.19 girls per
100,000).

Almost 65,000 children are sexually abused.

2018 is the first year for which states are reporting the new maltreatment
type of sex trafficking. For 2018, 27 states report 741 unique victims of sex
trafficking.

For victims of the sex trafficking maltreatment type, the majority (89.1%)
are female and 10.4% are male.

It is estimated that between 50% to 60% of maltreatment fatalities are not
recorded on death certificates.
New York State Data
The Kids’ Well-Being Indicators Clearinghouse (KWIC) gathers and reports data that
focuses on youth abuse/maltreatment occurring in New York state. KWIC reports on the
number and rate of abuse/maltreatment per 1,000 youth aged between 0-17 years
(KWIC, 2021).
KWIC, as of March 17, 2021, reports that in New York there were 79,668 reports of
abuse/maltreatment. This indicates a rate of 18.6 per 1,000 youth aged between 0-17
(KWIC, 2021).
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And as a general update, in 2020, the New York State Social Services Law was
amended, increasing the legal standard for determining that someone maltreated a
child, shortening the length of time before records of neglect are sealed, and providing
protections for accused parents before employers can access records (Gottlieb, 2020).
COVID-19 and Abuse/Maltreatment
In May 2020, Antonio Guterres, Secretary General of the U.N., suggested that the
COVID-19 pandemic is rapidly becoming a “broader child rights crisis” (United Nations
International Children’s Emergency Fund (UNICEF), 2020). The risk factors for violence
against children, such as loss of job, financial stress, and worries about health, were
exacerbated during the peak of the COVID-19 pandemic (Ingram, 2020).
The stressors triggered by the pandemic threatened the safety of children. This is
especially true for children who were denied their freedom of movement, are homeless,
who are living on the streets, in institutions, or in situations of conflict (e.g. war zones)
as refugees, or migrants (UNICEF, 2020).
Experts fear that abuse increased beyond the current counts due to school closures
(Ingram, 2020). School closures kept students away from teachers and school
officials—teachers and school officials file a fifth of all child abuse reports.
Experts and researchers say that directly alleviating financial burdens can reduce
maltreatment. One study showed that raising the minimum wage by one dollar reduced
reports of child maltreatment by almost 10% (Ingram, 2020). Experts note that a focus
on reducing poverty can help to reduce abuse and maltreatment.
In conjunction with reducing financial problems, programs offering mental health
services and substance abuse counseling are additional ways to help curb incidence of
abuse and maltreatment (Ingram, 2020).
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Risk Factors
Child Risk Factors
Factors such as a child’s age and physical mental, emotional and social development
can contribute to an increased risk for child abuse. Infants and young children are
especially vulnerable because of their small physical size, early developmental status,
and their need for constant supervision and care. These children are quite susceptible
to specific forms of abuse and maltreatment including abusive head trauma and
physical or medical neglect. Children with physical and/or mental health issues, and
those with developmental disabilities are also especially vulnerable to abuse (Centers
for Disease Control and Prevention (CDC), 2021b; Child Welfare Information Gateway,
n.d.).
Individual Parent or Caregiver Risk Factors
Factors linked to an increase in an individual’s risk of becoming abusive include the
following factors (CDC, 2021b; Child Welfare Information Gateway, n.d.):

History of being abused or neglected as a child.

Physical or mental illness such as depression.

Family stress such as domestic violence, marital conflicts, or being a
single parent.

Financial stress such as poverty or unemployment.

Social or extended family isolation.

Lack of education and understanding of child development.

Lack of education and understanding of parenting skills.

Substance abuse issues.

Lower socioeconomic status.

Using spanking and other forms of corporal punishment as a type of
discipline.

Teenage parents.

Having attitudes that are accepting of violence or aggression.
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Family Risk Factors
Research suggests that in 30% to 60% of families where spousal abuse takes place,
child maltreatment also occurs. Children who witness parental violence may very well
be physically abused themselves. Even if physical abuse does not occur, the children
may suffer emotionally by witnessing violence (Child Welfare Information Gateway,
n.d.).
Additional family risk factors include (CDC, 2021b:

Family members are jailed or in prison.

Families are isolated from other people (including extended family, friends,
and neighbors).

Families who have high conflict and negative communication styles.
Community and Environmental Risk Factors
Communities and environments with the following characteristics place children at
greater risk of abuse (CDC, 2021b):

High rates of violence and crime.

High rates of poverty and limited educational and economic opportunities.

High rates of unemployment rates.

Low community involvement with neighbors.

Few community opportunities for young people.

Unstable housing.

Food insecurity.
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Types of Child Abuse and Maltreatment
Physical Abuse
The state of New York defines physical abuse when a parent/caretaker hurts or lets
someone else hurt a child physically, or creates a substantial risk that a child will be
hurt. There must be serious injury or risk of serious injury such as a severe burn, a
broken bone, the loss of a body part, an internal injury or death. The injury or risk of
injury must not be due to an accident (New York State Office of Children & Family
Services, 2007).
Additional characteristics of physical abuse include the occurrence of or risk of serious
disfigurement, impairment of physical or emotional health, and loss of bodily function or
death. Examples of physical abuse includes beating, burning, biting, shaking, and
excessive corporal punishment (Rizvi et al., 2021).
Scalding and immersion burns are common forms of deliberate burning. Deliberate
burns are symmetric and uniform in depth.
In children younger than one year of age, an estimated 25% of fractures are due to
abuse (Brown et al., 2020).
Fractures that suggest abuse include (Brown et al., 2020):

Fractures occurring in an infant who is non-mobile.

Fractures that are multiple and unexplained.

Fractures that show evidence of occurring at different times.

Rib fractures in children younger than 1.5 years. In fact, seven in 10 of
these types of fractures are due to abuse.

Femur fractures in children less than 1.5 years. One in three femur
fractures in this age group are due to abuse.

Skull fractures in children less than 1.5 years. In this age group, one in
three skull fractures are due to abuse.
It is important to be able to distinguish abuse from accident. Accidents do happen.
Children run, jump, and explore their environments. When observing physical injury,
there are characteristics that help to distinguish between the two (Clermont County,
2016).
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Location of the injury – Accidental injury is more likely to occur over the knees, elbows,
shins, and forehead. Protected or parts of the body that do not protrude (such as the
back, thighs, genital area, buttocks, back of the legs, or face) are less likely to be the
site of accidental injury. For instance, bruised shins are likely to be accidental. Bruising
over the genital area or back for example, are less likely to be accidental.
Number of injuries – The more injuries noted, the greater the cause for concern.
Accidents are not likely to cause a number of different injuries unless the accident is
quite serious. Injuries in various stages of healing can be a “red flag” that suggests a
chronological pattern of abuse.
Appearance of the injury – Injuries that can suggest abuse include those that have a
specific pattern or shape, such as the shape of a belt buckle, a hairbrush, or the imprint
of a hand. The bruising resembles the object that was used to cause the injury. Bruising
from accidents, rather than abuse, typically have no defined pattern or shape.
Description of the occurrence – Is the description of how the injury occurred reasonable
and is the injury itself consistent with the severity and type of explanation? For example,
if the parent says the child fell and struck his head on a table, but there are multiple
bruises, the explanation does not match the injury.
Child development and injury – Development stages consist of new activities that can
lead to injury. For example, a toddler learning to walk is likely to fall and sustain a bump
on the head or bruised knees. A seven-year-old learning to ride a bicycle could easily
sustain a broken arm after a fall. The toddler is less likely to suffer a broken arm given
his developmental level and developmental activities.
Abusive Head Trauma
Abusive head trauma (AHT) is the leading cause of death from physical abuse in
children less than two years of age (Brown et al., 2020).
AHT is defined as injury to the intracranial contents or skull of an infant or child usually
less than five years of age that is due to violent shaking or blunt impact. AHT usually
causes cerebral edema, retinal hemorrhage, and subdural hematoma. The CDC and
the American Academy of Pediatrics have recommended using the term AHT for
injuries due to shaking, blunt impact, suffocation, and strangulation. The term also
includes injuries resulting from dropping and throwing a child. The majority of AHT
victims are less than one year of age, and often between three to eight months of age
(Joyce et al., 2021).
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AHT is the leading cause of death and disability in infants and young children from child
abuse. Child abuse is noted as the primary cause of brain injuries in 25% of children
older than two years old (Joyce et al., 2021).
Identified risk factors for AHT include the following issues (Joyce et al., 2021):

Infants who cry for long periods of time and/or cry inconsolably are at risk
for violent shaking by a frustrated caregiver. Infant crying is greatest when
the infant is between six to eight weeks of age and then decreases.
Research shows that head injury peaks at six to eight weeks of age.

Colic is also a risk factor. Colic can cause inconsolable crying.

Single-parent families have a higher incidence of AHT.

Caregivers with a low level of education and/or low socioeconomic status
are at greater risk for committing AHT.

A mother’s lack of prenatal care increases risk.

Parents and caregivers, especially those who are young, who do not have
emotional support are at higher risk for committing AHT.

Parents and caregivers with behavioral health problems are at higher risk
for committing AHT.
AHT perpetrators are most often the father, stepfather, mother’s boyfriend, female baby
sitter, and the mother. Shaking is often linked to an increased level of frustration and
tension of the parent or caregiver (Joyce et al., 2021).
The person committing AHT is typically a parent or caregiver, and 65% to 90% of
perpetrators are male. It is estimated that between 1200 and 1400 children are injured
or killed by AHT annually in the United States (Joyce et al., 2021).
Clinical signs and symptoms of AHT include (Brown et al., 2020):

Retinal hemorrhages

Crying

Shock and coma

Irritability

Sleepiness

Fever

Vomiting

Respiratory distress, and/or apnea.
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An estimated 30% to 70% of victims have other injuries such as rib fractures and
bruising.
It is important to note that the New York state Penal Law states that a parent is “allowed
to use physical force on a child to the extent that he/she reasonably believes it
necessary to maintain discipline or to promote the child’s welfare” (Gherman, 2020).
Parents and caretakers are not to use punishment that is brutal or beastly. I should not
be extended beyond the child’s power of endurance. New York state courts are guided
by the concept that force applied mainly for the purpose of the child’s proper training or
education, or for the preservation of discipline, is reasonable. Corporal punishment
inflicted for the purpose of gratification of passion or rage is considered excessive
punishment (Gherman, 2020).
Corporal punishment as a form of discipline is a controversial subject in the United
States. About half of all states, including California and Massachusetts, have outlawed
corporal punishment. The difference between legalized corporal punishment and abuse
may be difficult to determine. A quick slap or a spanking is typically allowed by the law.
However, if the discipline reaches the point of prolonged physical force or intense force,
and if there are lasting physical and psychological harm, that is, by most definitions
under the law, child abuse (Tuthill, 2020).
Neglect & Maltreatment
The state of New York describes neglect as occurring when a parent or caretaker does
not provide for a child’s basic needs when the parent or caretaker has the means or is
offered a way to fulfill these needs. Neglect also includes the failure of a parent or
caretaker to supervise a child or hitting a child too hard (New York State Office of
Children and Family Services, 2007).
Neglect is the finding in 61% of child maltreatment cases. It is the leading reason for
entry into the foster care system (New York State Office of Children and Family
Services, 2007).
Signs and symptoms of neglect include (Mayo Clinic, 2018; New York State Office of
Children and Family Services, 2007):

The child wears clothing inadequate to the time of year and the weather
on a consistent basis.

The child’s clothing, hair, and/or body are very dirty.

The parents or caregivers do not seek, or wait too long to seek, healthcare
necessary for the child’s health and wellbeing.
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
Parents or caregivers do not provide adequate supervision, such as
leaving a young child alone or allowing the child to engage in dangerous
activities.

Parents or caregivers prevent the child from attending school.

Parents or caregivers withhold affection and emotional support from the
child.

The child may take food or money from others without permission
because of hunger and the lack of other necessary items.

Parents or caregivers show minimal concern for the child and appear
unable to recognize physical or emotional distress of the child.
Emotional Abuse
The New York state definition of emotional abuse is the non-physical maltreatment of a
child (under 18 years old) that can seriously interfere with his/her development (NYC
Administration for Children’s Services (ACS); Rizvi et al., 2021). Patterns of emotional
abusive behavior can seriously interfere with the children’s positive emotional
development (Rizvi et al, 2021).
Examples of abusive emotional behavior include (Mayo Clinic, 2018; Rizvi et al., 2021):

Constant rejection of the child.

Terrorizing the child.

Constantly criticizing and/or embarrassing the child.

Exposing the child to corruption, violence, or criminal behavior.

Verbal abuse (excessive yelling, belittling, and teasing).
A child who has been emotionally abused may exhibit (Mayo Clinic, 2018):

Delayed or inappropriate emotional development.

Significant loss of self-confidence or self-esteem.

Withdrawal from friends and social situations.

Loss of interest or enthusiasm.

Symptoms of depression.

Desperately seeking affection.

Decrease in performance at school.

Loss of previously acquired developmental skills.
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Sexual Abuse
Sexual abuse is defined as “the involvement of dependent, developmentally immature
children in sexual activities that they do not fully comprehend, to which they are unable
to give consent, or that violate the social taboos of family roles. Sexual abuse and
maltreatment include situations in which the parent, caregiver, or another person legally
responsible for a child under 18 years of age, commits or allows to be committed any
one of the following activities” (Mayo Clinic, 2018; Rizvi, 2021):

Touching a child’s mouth, genitals, buttocks, breasts, or other intimate
parts in order to gratify sexual desire.

Forcing or encouraging a child to touch the parent/caregiver in intimate
ways for the purpose of sexual gratification.

Forcing, engaging, or trying to force or engage the child in sexual
intercourse and/or sodomy.

Forcing or encouraging a child to participate in sexual activity with other
children or adults.

Exposing a child to sexual activity or exhibitionism (including exposing the
child to pornographic materials or exposing parts of the body in order to
gain sexual satisfaction).

Allowing a child to engage in sexual activity that is not appropriate to their
developmental stage and causes the child to suffer emotional damage.

Using a child in a sexual performance (e.g., photos, plays, motional
pictures or dance) no matter if the material is pornographic.
Signs and symptoms of sexual abuse include (Mayo Clinic, 2018):

Sexual behavior or knowledge of sexual behavior that are inappropriate
for the child’s age.

Becoming pregnant or acquiring a STD.

Complaints of being sexually abuse.

Sexual contact with other children that is inappropriate.
Sex Trafficking
Sex trafficking is defined as the “recruitment, harboring, transportation, provision,
obtaining, patronizing, or soliciting of a person for the purpose of a commercial sex act”
(Victims of Trafficking and Violence Protection Act of 2000, 2000). There are an
estimated 4.8 million victims of ST throughout the world. About 21% of these victims are
children or adolescents (International Labour Organization, 2017).
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Risk factors for sex trafficking include the following factors (Fazio, et al., 2021):

Children and adolescents who have been abused.

Parental/caregiver substance abuse issues.

Children and adolescents who have witnessed intimate partner violence.

Children and adolescents who have left countries experiencing war or
terrorism in search of a better life. Sex traffickers often lure these victims
with promises of better living conditions.

Members of the lesbian/gay/bisexual/transgender/questioning (LGBTQ)
community are at particularly high risk.

Children and adolescents who are homeless.

Children and adolescents who live in dysfunctional families.

Children and adolescents who live in areas of poverty, high crime rates, or
prostitution.
Victims of sex trafficking visit healthcare facilities (e.g., clinics, emergency departments)
for problems that may or may not be directly related to sex trafficking. Sadly, healthcare
professionals may lack the necessary knowledge to identify these victims. Signs of sex
trafficking include physical injury, sexually transmitted infections (STIs), exacerbation of
chronic conditions, substance misuse, and reproductive issues. The victim’s abuser
may accompany the victim and refuse to leave the victim alone with healthcare
professionals. The victim may exhibit fear of the perpetrator as well (Fazio et al., 2021).
Review Questions
1. Based on the information provided, which of these children is likely to have been abused?
A.The little girl.
B.The little boy.
C.Neither child.
D.Both children
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2.When reviewing the children’s injuries, it is important to note that:
A.Children of these ages normally have fractures when injured.
B.Toddlers are less likely to suffer broken arms at this development level.
C.The little girl’s injuries are not consistent with the father’s description of how they occurred.
D.Both children’s injuries are suspicious.
3.What actions should the nurse and x-ray technologist take?
A.The x-ray technologist should call the mandated reporter hot line.
B.The nurse and the x-ray technologist should call the mandated reporter hot line about the both
of the children’s injuries.
C.The nurse should report the little girl’s father as a potential abuser.
D.There is no reason for either healthcare professional to call the mandated reporter hotline.
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References
1. American Society for the Positive Care of Children (American SPCC).
(2021). Child abuse statistics. https://americanspcc.org/child-abusestatistics/
2. Brown, C. L., Yilanli, M. & Rabbitt, A. L. (2020). Child physical abuse and
neglect. https://www.ncbi.nlm.nih.gov/books/NBK470337/
3. Centers for Disease Control and Prevention (CDC). (2021a). Prevention
strategies.
https://www.cdc.gov/violenceprevention/childabuseandneglect/prevention.
html
4. Centers for Disease Control and Prevention (CDC). (2021b). Risk and
protective
factors. https://www.cdc.gov/violenceprevention/childabuseandneglect/risk
protectivefactors.html
5. Centers for Disease Control and Prevention (CDC). (2021c). What are
child abuse and
neglect? https://www.cdc.gov/violenceprevention/childabuseandneglect/fa
stfact.html
6. Child Protective Services. (2016). Abuse versus accident.
https://cps.clermontcountyohio.gov/abuse-versus-accident/
7. Clermont County. (2016). Distinguishing abuse from accident.
https://cps.clermontcountyohio.gov/abuse-versus-accident/
8. Gottlieb, C. (2020). Major reform of New York’s child abuse and
maltreatment
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register. https://www.law.com/newyorklawjournal/2020/05/26/majorreform-of-new-yorks-child-abuse-and-maltreatmentregister/?slreturn=20210217201801
9. Child Welfare Information Gateway. (n.d.). Risk factors that contribute to
child abuse and neglect. https://www.childwelfare.gov/topics/can/factors/
10. Fazio, N., Lynch, J., Devlin, M., & Kameg, B. (2021). Mental health
problems among youoth experiencing sex trafficking. Nursing 21, 51(3),
25-30.
11. Gherman, Il. (2020). Child abuse and neglect.
(https://www.nysdivorcelawyer.net/child-abuse-and-neglect.html
12. Govinfo.gov. (2000). Victims of trafficking and violence protection
act. https://www.govinfo.gov/content/pkg/PLAW-106publ386/pdf/PLAW106publ386.pdf
13. Ingram, J. (2020). Has child abuse soared under COVID-19? Despite
alarming stories from ERs, there’s no
answer. https://www.nbcnews.com/health/kids-health/has-child-abusesurged-under-covid-19-despite-alarming-stories-n1234713
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trauma. https://www.ncbi.nlm.nih.gov/books/NBK499836/
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slavery: Forced labour and forced marriage.
https://www.ilo.org/global/publications/books/WCMS_575479/lang-en/index.htm
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indicator: Child abuse/maltreatment children/youth in indicated reports of
abuse/maltreatment.
https://www.nyskwic.org/get_data/indicator_profile.cfm?subIndicatorID=10
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17. Mayo Clinic. (2018). Child abuse. https://www.mayoclinic.org/diseasesconditions/child-abuse/symptoms-causes/syc-20370864
18. New York State Office of Children & Family Services. (2007). What is child
abuse and
maltreatment? https://ocfs.ny.gov/main/publications/Pub5056text.asp
19. New York State Office of Children & Family Services. (2019). Summary
guide for mandated reporters in New York
state. https://on.ny.gov/Mandated
20. New York State Office of Children & Family Services. (2021). Who are
mandated reporters?
https://nysmandatedreporter.org/MandatedReporters.aspx
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21. New York State Senate. (multiple dates). Family court: Court acts of New
York. https://www.nysenate.gov/legislation/laws/FCT
22. NYC Administration for Children’s Services (ACS). (2007). Parents’ guide
to New York state child abuse and neglect
laws. https://www1.nyc.gov/assets/acs/pdf/stateguide_english.pdf
23. Rizvi, M. B., Conners, G. P., & Rabiner, J. (2021. New York state child
abuse, maltreatment, and
neglect. https://pubmed.ncbi.nlm.nih.gov/33351402/45
24. Save the Children Federation. (2020). The hardest place to be a child.
Global childhood report
2020. https://www.savethechildren.org/content/dam/usa/reports/advocacy/
global-childhood-report-2020.pdf
25. Statista. (2020). Number of unique victims of child abuse in the U.S. in
2019, by state. https://www.statista.com/statistics/203841/number-of-childabuse-cases-in-the-us-by-state/
26. Tuthill, S. R. (2020). When does discipline become
abuse? https://www.lawinfo.com/resources/criminal-defense/when-doesdiscipline-become-abuse.html
27. United Nations International Children’s Emergency Fund (UNICEF).
(2020). COVID-19: Protecting children from violence, abuse, and neglect
in the home. https://www.unicef.org/media/68711/file/COVID-19Protecting-children-from-violence-abuse-and-neglect
28. World Health Organization (WHO). (2020). Child
maltreatment. https://www.who.int/news-room/fact-sheets/detail/childmaltreatment.
29. World Health Organization (WHO), United Nations Education, Scientific,
and Cultural Organization (UNESCO), United Nations International
Children’s Emergency Fund (UNICEF), & the United Nations (UN)
Secretary-General’s Special Representative on Violence against Children,
& Global Partnership to End Violence Against Children. (2020). Global
status report on preventing violence against children
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