How can a mandatory reporter, or even untrained members of the general public, identify child abuse?
According to the Department of Social Services Office of Child Abuse Prevention, identifying where child abuse occurs requires the helping professional first of all to believe that child abuse can occur in any situation, regardless of socioeconomic status, religion, education, ethnic background, or other factors. Secondly, there must be a willingness to inquire into the possibility of abuse. There are four basic areas in which abuse may be revealed: (1) environmental problems, (2) parental or caregivers clues, (3) physical indicators in the child, and (4) behavioral indicators in the child.
A potential list of these signals, as provided by the Department of Social Services Office of Child Abuse, is provided below. However, this is only a partial list. These may become known through interview, observation or a third party reporting them.
Environmental problems which may suggest that abuse should be a concern:
(1) Hazardous conditions (broken windows, faulty electrical fixtures, etc.), (2) Health risks (presence of rats, feces, no running water, no heat, etc.) or unsanitary conditions, (3) extreme dirt or filth affecting health.
Parental or caregiver clues which may suggest that abuse should be a concern:
(1) Parent or caregiver is unable/unwilling to meet child's basic needs and provide a safe environment, (2) Parent or caregiver tells you of homicidal thoughts/feelings toward child, (3) Parent or caregiver tells you of use of objects (belts, whips, clothes hanger) to discipline the child, (4) Parent or caregiver is unable to describe positive characteristics of the child, (5) Parent or caregiver has unrealistic expectations of the child (e.g., toilet-training of a 6 month-old), (6) Parent or caretaker uses "out of control" discipline, (7) Parent or caretaker is unduly harsh and rigid about childrearing, (8) Parent or caretaker singles out one child as "bad", "evil", or "beyond control", (9) Parent or caretaker berates, humiliates or belittles child constantly, (10) Parent or caretaker turns to child to have his/her needs met, (11) Parent or caretaker is impulsive, unable to use internal controls, (12) Parent or caretaker cannot see child realistically, attributes badness to child, or misinterprets child's normal behavior (e.g. takes an infant's crying as a sign of intentional meanness), (13) Parent or caretaker is indifferent to child.
Signs of physical injury which may suggest that abuse should be a concern:
(1) fractures, lacerations, bruises that cannot be explained or explanations which are improbable given the extent of the injury, or which are not age-appropriate (e.g. traumatic injuries in an immobile, young child - which would mean that it had to be inflicted versus a toddler who could feasibly fall and injure himself or herself in certain ways), (2) burns (cigarette, rope, scalding water, iron, radiator), (3) facial and oral injuries (black eyes, broken jaw, broken nose, bloody or swollen lips, torn frenulum) with implausible or non-existent explanations, (4) subdural hematomas, long-bone fractures, fractures in different state of healing, (5) pattern of bruising (e.g. parallel or circular bruises) or bruises in different stages of discoloration, which are consistent with repeated trauma over various periods of time.
Behavioral or development signs which may suggest that neglect should be a concern:
(1) failure to thrive, a child's failure to gain weight at the expected rate for a normal child (e.g. a child who fails to thrive may have medical or psychosocial problems, or a combination of these, (2) malnutrition or poorly balanced diet (bloated stomach, extremely thin, dry, flaking skin, pale, fainting), (3) inappropriate dress for weather, (4) extremely offensive body odor, (5) dirty, unkempt, (6) unattended medical conditions (e.g. infected minor burns, impetigo).
Signs of sexual abuse:
(1) bruising around the genital area, (2) swelling or discharge from vagina/penis, (3) tearing around the genital area, including rectum, (4) visible lesions around mouth or genitals, (5) complaint of lower abdominal pain, (6) painful urination, defecation.
According to the Department of Social Services Office of Child Abuse Prevention, there are also behavioral indicators that a child has been abused. Children react differently to being abused. There is no one single reaction that can be clearly associated with child abuse; however, there are a number of possible behaviors which have been found to be consistently correlated with abuse. While some of these behaviors occur more with one type of abuse than another, they may overlap. The presence of any of these indicators does not prove the child is being abused, but should serve as a warning signal to look further.
Behavioral indicators that a child has been physically abused:
(1) hostile or aggressive behavior toward others, (2) extreme fear or withdrawn behavior around others, (3) destructiveness (breaks windows, sets fires, etc.), (4) verbal abusiveness, (5) out-of-control behavior (angry, panics, easily agitated).
Behavioral indicators that a child has been sexually abused:
(1) sexualized behavior (has precocious knowledge of explicit sexual behavior and engages self or others in overt or repetitive sexual behavior), (2) hostility or aggression, (3) fearfulness or withdrawn, (4) pseudo-maturity (seems mature beyond chronological age), (5) eating disorders, (6) alcoholism/drug abuse, (7) running away, (8) promiscuity.
Behavioral indicators that a child has been neglected:
(1) clingy or indiscriminate attachment, (2) self-imposed isolation, (3) depression or passivity.
Behavioral indicators that a child has been subject to emotional abuse:
(1) lacks self-esteem, puts self down constantly, (2) seeks approval to an extreme, (3) unable to be autonomous (e.g. makes few choices, fears rejection), (4) hostile, verbally abusive, provocative.
According to the Department of Social Services Office of Child Abuse Prevention, it is important to note that a child who is being physically abused or neglected or sexually abused is also being emotionally abused. The best source of information is not what the child says but how the child behaves. Mandated reporters must stay alert and responsive to the aforementioned child behaviors. Children will rarely report they are being abused; but, being unable to stop the abuse, they frequently develop coping mechanisms and behaviors which bring them to the attention of others. These children tend to be firecely loyal to their abusers, often demonstrating a pathological dependency on them. They may try to adapt and comply in order to please their abusers and may serve as caretakers to their abusers in order to avoid further abuse or rejection.