Child Abuse and Neglect

In the year 2001, an average of 2,475 children were found to be victims of child abuse each day. Abuse and neglect are associated with short- and long-term consequences that affect not only the child and family, but society as a whole.1 Providers should check all infants, children, and teens for excessive bruising, injuries, and other possible signs of abuse or neglect at each preventive health visit.

Child Abuse and Neglect Risk Factors

All the causes of abuse and neglect are not known, but research has identified a number of risk factors:²

• Lack of preparation for parenthood
  
• Financial or emotional stressors
  
• Relationship difficulties
  
• Stresses of single parenting
  
• Depression or other mental health problems

Preventing Child Abuse and Neglect

Providers can help to prevent child abuse and neglect by educating families and offering anticipatory guidance on the following topics: ³

• Developmental and behavioral concepts
  
• Reasonable expectations of abilities
  
• Alternatives to corporal punishment
  
• Health, hygiene, and nutritional needs
  
• Shaken baby syndrome
  
• Coping strategies and anger management
  
• Parenting classes and support groups

Professional Reporting Responsibilities

DC's child abuse law, the Prevention of Child Abuse and Neglect Act of 1977 (D.C. Law 2-22), is designed to protect providers as they help DC protect its children.

Under the law, providers are responsible for reporting any child known to them in a professional capacity whom they suspect of being at risk for physical or mental abuse or neglect.

All persons involved in the care and treatment of children and teens must report suspected child abuse and neglect.

This includes:

Penalty for Not Reporting

"Any person required to make a report … who willfully fails to make such a report shall be fined not more than one hundred dollars ($100) or imprisoned for not more than thirty (30) days or both” (if prosecuted and found guilty).

Recognizing Abuse

Providers must make a report if they observe or hear about one or more of the following situations:

• Non-accidental injuries that are inadequately explained by parent or caregiver
• Bruises or wounds in various stages of healing (consider the repetitiveness or the seriousness of the injury)
• Injuries that appear to have been caused by blows, beating, physical violence, or the use of a weapon
• Other signs of harsh punishment, sexual abuse, or exploitation
• A child's reluctance to discuss his/her injuries or apparent fear of a parent or caregiver

Recognizing Neglect

Major neglect includes the following:

• Physical evidence of insufficient food or water; poor skin tone
• Inadequate clothing or clothing not appropriate for the weather
• Poor personal care of the child, such as being unwashed
• Inadequate shelter or filthy, cold, overcrowded or hazardous living conditions
• Inadequate supervision or lack of supervision

Making a Report

A report can be made by calling the DHS Child Protective Services Division's 24-hour hotline at (202) 671-SAFE (7233).

If requested, follow the oral report with a written report.

Information Included in a Report

A written report must include the name, age, sex, and address of the following individuals:

• The child who is the subject of the report
• Brothers and sisters of the child
• The parents of the child or others responsible for his/her care

Additionally, the report must contain the following information:

• The nature and extent of the abuse or neglect and any previous abuse or neglect
• Any other information that may be helpful in establishing the cause and the identity of the person responsible
• The name, occupation, address, and phone number of the person making the report and a statement of any action taken concerning the child

Report all known information. Do not hesitate to file a report even if answers to some items are unknown.

Call the Child USA National Child Abuse Hotline at 1-800-4-A-CHILD for crisis counseling, referral services, additional health education information, and posters on child abuse.

1. Child Abuse Prevention: An Overview. In National Clearinghouse on Child Abuse and Neglect Information [Web site]. Cited March 29, 2004; available at http://nccanch.acf.hhs.gov/topics/prevention/overview/index.cfm.

2. Child Abuse Prevention: An Overview. In National Clearinghouse on Child Abuse and Neglect Information [Web site]. Cited March 29, 2004; available at http://nccanch.acf.hhs.gov/topics/prevention/overview/prevention.cfm.

3. Jellinek M, Patel BP, Froehle MC, eds. 2002. Bright Futures in Practice: Mental Health—Volume I. Practice Guide. [chapter on Child Maltreatment: pp. 213-225]. Arlington, VA: National Center for Education in Maternal and Child Health. Also available online at www.brightfutures.org/mentalhealth/index.html.