What is Child Abuse and Neglect? Abuse or neglect are defined as a threat to a child’s health or welfare due to physical, mental or emotional injury or impairment, sexual abuse or exploitation, deprivation of essential needs or lack of protection from these by a parent or caregiver who is responsible for the child. Types of Abuse Physical abuse State of Maine DHHS Definition: Abusive treatment to a child by a parent or caregiver that caused or is likely to cause physical injury. Injuries may include bruises, lacerations, adult bites, burns, fractures, and head trauma. Emotional abuse State of Maine DHHS Definition: Abusive treatment by a parent/caregiver that has resulted in emotional impairment or distress in a child. Neglect State of Maine DHHS Definition: Failure to provide adequate food, clothing, shelter, supervision, or medical care causing or is likely to cause injury including accidental injury or illness. Also failure to protect a child from harm resulting in physical abuse, sexual abuse or emotional abuse. Sexual abuse State of Maine DHHS Definition: A parent/caregiver engaged in sexual contact with a child, or forces a child to have sexual contact with others. Most Common Risk Factors Associated with Child Abuse and Neglect in Maine Children under six years of age Uncontrolled Mental Illness/Behavioral Issues Physical Health Problems Alcohol/Drug Misuse by Parent/Caregiver Family Violence Problems Functioning at School (truancy, behavioral issues) Severe Parent/Child conflict **Note: The absence of these risk factors does not mean that abuse or neglect has not occurred** General Indicators of Physical Abuse • • • Injury is inconsistent with the explanation being offered Different or changing explanations of the injury by caregiver or child Injury is inconsistent with the developmental age of the child; (e.g., any bruise or fracture in a non-ambulatory infant) Child or caretaker states/discloses that the injury was inflicted • Bruises • • • • Multiple locations on the body Both arms, legs, or both sides of the face Pattern of an implement such as a hand or belt Unusual locations for an accident such as the buttocks, neck, earlobes, upper arms, and legs (Consider where a child of a particular age would typically have bruises) Adult bites Any injury in an infant younger than 6 months • • Burns • • • Cigarette burns Immersion burns Pattern burns (e.g., electric burner, iron, lighter, hairdryer, etc) ALL TYPES OF ABUSE INCLUDE EMOTIONAL ABUSE. Fractures • • Approximately 30% of all childhood fractures are inflicted In children under 1 year, 75% of fractures are inflicted Consider the Possibility of Physical Abuse When: A child has unexplained injuries (e.g., bites, burns, black eyes, broken bones) A child has fading bruises or other marks noticeable after an absence from school A child seems frightened of the parents/caregivers and protests or cries when it is time to go home A child shrinks/withdraws at the approach of adults A child reports an injury by a parent or another adult caregiver A caregiver offers conflicting, unconvincing, or offers no explanation for the child’s injury A caregiver describes the child as “evil”, or in some other negative way A caregiver uses harsh physical discipline with the child A child or caregiver discloses abuse ALL TYPES OF ABUSE INCLUDE EMOTIONAL ABUSE. General Indicators of Emotional Abuse The following behaviors on the part of parents or caretakers convey the message that the child is worthless, flawed, unloved, endangered, or only valuable in relation to how well the child meets someone else’s needs. Hostility, Rejection, Degradation o Spurning Verbal/nonverbal rejecting and degrading a child (e.g., belittling, degrading, hostility, rejecting treatment, shaming, ridiculing the child for showing normal emotions), consistently singling out one child to criticize and punish, public humiliation Terrorizing o Threatens or is likely to physically hurt, kill, abandon, or place the child or child’s loved ones or objects in recognizably dangerous situations Isolating o consistently deny the child opportunities to meet her/his needs for interacting or communicating with peers or adults inside or outside the home. For example, confining the child or placing unreasonable limitations on the child’s freedom of movement within her/his environment. Exploiting/ Corrupting o encourage the child to develop inappropriate behaviors that are self-destructing, antisocial, criminal, deviant, and/or other maladaptive behaviors Denying Emotional Responsiveness o ignoring the child’s attempts and needs to interact, showing no emotion in interactions with the child. For example, being detached and uninvolved through either incapacity or lack of motivation, interacting only when absolutely necessary, and/or failing to express affection, caring, and love for the child. Consider the Possibility of Emotional Abuse When: A child demonstrates extremes in behavior (e.g., overly compliant, overly demanding) A child behave inappropriately “adult-like” or inappropriately “infantile” A child is delayed in physical or emotional development or suffers from recurring illnesses repeatedly A child talks about or attempts suicide A child demonstrates a lack of attachment to the caregiver(s) A caregiver constantly blames, belittles or berates the child A caregiver seems unconcerned about the child and refuses to consider offers to assist the child A caregiver overtly rejects the child General Indicators of Neglect o o o o o o o o o o Underweight/overweight Consistent hunger Poor hygiene Inadequately dressed for the weather Lack of basic needs being met (including food, shelter, and/or clothing) Unattended needs (including medical, dental, visual, developmental, and mental health needs) Left alone, unsupervised, for long periods of time (depending on child’s age and maturity) Child left with inappropriate/unsafe caregiver Unsafe/Unsanitary housing likely to cause injury/illness Educational Neglect A student is habitually truant if: • The student is 7-17 years old • The student has the equivalent of 10 full days of unexcused absences or 7 consecutive days of unexcused absences during a school year • School has taken steps to resolve the truant behavior by scheduling a meeting with the parents • The school is the only party that can report Educational Neglect **The above procedures apply to families who are reported to the Department of Health and Human Services solely for habitual truancy. However, school attendance issues may be a symptom of other types of abuse or neglect.** Some parental/caregiver behaviors and conditions that may cause poor school attendance include: • • • • Parental substance abuse can cause incapacitation to the extent that young children are on their own to get ready for school. Children may be kept home from school to conceal injuries caused by parental abuse. Uncontrolled parental mental illness may be impacting parental capacity. Children may be kept home to prevent the child from disclosing sexual abuse. Consider the Possibility of Neglect When: A child begs or steals food or money from classmates A child lacks necessary medical or dental care (immunizations, glasses, etc.) A child is consistently dirty and has severe body odor A child lacks appropriate clothing for weather A caregiver appears indifferent to the child, apathetic or depressed A caregiver behaves irrationally or in a “bizarre” manner A child or caregiver discloses neglect ALL TYPES OF ABUSE INCLUDE EMOTIONAL ABUSE. General Indicators of Sexual Abuse • • Sexual offender of children has uncontrolled access to children Parent/caregiver is intentionally subjecting a child to purposefully suggestive remarks and behaviors, creating a sexualized environment that is likely to result in sexual abuse or exploitation Behavioral Indicators of Sexual Abuse • • • • Inappropriate sexual knowledge or behavior for the child’s age Disclosure or other concerning statements from the child Sleep Disturbance Exposure to a person who has sexually abused a child(ren) Physical Indicators • • • • • Unexplained genital injury Sexually transmitted infections Pregnancy Unusually poor hygiene Encopresis/Enuresis ALL TYPES OF ABUSE INCLUDE EMOTIONAL ABUSE. Consider the Possibility of Sexual Abuse When: A child has difficulty walking or sitting or demonstrates sudden and significant weight change A child suddenly refuses to change for gym or to participate in physical activities A child demonstrates sophisticated or unusual sexual knowledge and/or behavior A child contracts a venereal disease or becomes pregnant (particularly under the age of 14) A child wears torn, stained or bloody underclothing A child has frequent urinary tract or yeast infections A child attempts to or runs away from home, becomes withdrawn, depressed A caregiver appears unduly protective of the child (severely limits the child’s contact with others) A caregiver is secretive and isolated A caregiver describes marital difficulties involving family power struggles or sexual relations A child or caregiver discloses sexual abuse **It is important to note that often there are no evident physical indicators of sexual abuse.**