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Infant Toddler Development Training
Module 6, Lesson 4

Child Abuse and Neglect: Reporting Requirements

baby breast-feedingChild abuse and neglect is behavior outside the norm of conduct by a caregiver and entails a substantial risk of causing physical or emotional harm to a child, including traumatic brain injury. Child abuse and/or neglect can lead to a physical or emotional disability. The ITDS needs to know the signs and symptoms of child abuse and neglect in order that appropriate reporting is made and interventions instituted.

There are three recognized types of abuse: physical, sexual, and emotional. There are four types of neglect: physical, medical, educational, and emotional. The incidence of abuse and neglect by report is an overall rate of 23/1000 children: physical abuse, 3 – 6/1000 children; sexual, 3/1000 children, and neglect, 13/1000 children. The rate is increased 5 – 10 times when parents are surveyed retrospectively.

Physical abuse in infants and toddlers may be detected by the ITDS if the child has multiple unexplained bruises, scars, cuts, welts, or burns. However, sometimes the physical signs are not evident. In these cases, withdrawn or aggressive behaviors often become the first clue to the abuse.

Shaken Baby Syndrome is one of the most common forms of physical abuse. It is a form of head trauma in an infant or young toddler that can result in death or permanent disability. This occurs when a parent or other caregiver shakes the baby so hard that the head moves in a whiplash fashion. Often this is done in an attempt to quiet the baby. Most parents and caregivers who shake their babies do not know that the shaking action causes bleeding and swelling of the brain. The National Center on Shaken Baby Syndrome is a source of information for families, child care providers, and other professionals about this condition. The National Shaken Baby Syndrome Campaign is focusing attention on this problem. The ITDS can assist this educational effort by providing information to caregivers about the effects of Shaken Baby Syndrome. This may save an infant's life or prevent a disability.

Sexual abuse may occur with infants and toddlers. If the ITDS suspects that a child is being exposed to sexual contact, activity, or behavior that is inappropriate for the child's age, she/he must report this to child protective services or the police. Prevent Child Abuse America has a fact sheet which the ITDS can share with parents and other caregivers on Sexual Abuse of Children .

baby boy with odd look on his faceEmotional or verbal abuse is hard to discern at an early age. Sometimes the behaviors of the child and the caregivers lend clues to the emotional abuse. A very young child may be overly passive or overly aggressive. The child may appear depressed or withdrawn. The infant or toddler may be hard to engage or may engage inappropriately with strangers; yet show little connection to their primary caregivers. The caregiver's behavior can include shouting, belittling comments to the child, lack of affection toward the child, and rejection of the child's attempts to engage. Because there are no physical signs of the abuse, emotional abuse may go untreated. If the ITDS suspects emotional abuse, the team may want to consider involving an early intervention mental health counselor or social worker as the primary provider for the child and family.

Physical Neglect: Child neglect may result in delays of physical, communicative, and cognitive development. Signs of physical neglect include malnutrition; repeated pica (eating of dirt, paint, clay, etc.), physical fatigue, and poor hygiene.

Medical Neglect: Signs of medical neglect include the persistence of treatable medical conditions such as failure to have a child immunized or provide dental care. Medical neglect can include the absence of necessary prostheses, such as eyeglasses and hearing aids, or protective gear such as helmets.

Educational Neglect: Educational neglect is the failure of caregivers to ensure appropriate instructional programs and schooling for a child.

grandmother holding babyEmotional Neglect: Emotional neglect occurs when the caregiver is not able to attend to a child's needs for love, acceptance, and esteem building. The caregiver may be unable to bond with an infant for various reasons including her/his own emotional issues. If the primary caregiver is unavailable emotionally, the team may need to explore other options to support the emotional needs of the child. The team may consider means for providing another adult caregiver in the child's life to support the child's emotional needs. The team may also want to consider a mental health counselor or licensed clinical social worker to work with the primary caregiver and the child as a dyad. (A dyad is two people who are treated together as a unit such as a caregiver and a child).

The ITDS should be aware that contributors to child neglect include parental depression, social isolation, intellectual impairments, financial problems, substance abuse, limited education, unemployment, marital stress, and mental illness. Child factors that may contribute to neglect include medical illness, developmental delay, emotional or behavioral disturbance, and a lack of fit between the temperament of the child and parent. Overall factors of abuse and neglect are poverty, lack of support systems and community resources, domestic and community violence.

All instances of suspected or observed abuse and neglect must be reported. Complete information about Florida's laws on child abuse, including laws pertaining to mandatory reporting and protection of confidentiality, may be found at Department of Children and Families Child Abuse Program This program also offers educational programs for child care staff and support for families. Local Child Protection Team offices may be contacted for further information and resources.


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