Child Abuse Recognition and Reporting Training for Mandated Reporters

About this course

Child abuse and neglect are serious public health concerns. It involves the emotional, sexual, physical abuse, or neglect of a child under the age of 18 by a parent, custodian, or caregiver that results in potential harm, harm, or a threat of harm. Physical abuse can result in pediatric head trauma; namely shaken baby syndrome, which in severe cases, has a 20 % mortality rate. Victims of child abuse are often in contact with a mandated reporter, however often, the ailments of the child are not identified as potential child abuse. This independent study provides an overview of child abuse, Act 31 as it relates to child abuse, and reporting requirements in the state of Pennsylvania.

Learning objectives

• Recognize the risk factors, signs, and symptoms of child abuse
• Explain causes and potential injuries of pediatric head trauma
• Summarize common diagnostic tools and exams as they relate to child abuse and pediatric head trauma
• Understand Act 31 and child protections in Pennsylvania
• Outline the legal reporting requirements of child abuse in the state of Pennsylvania

Course outline

22 sections · finish in any order across devices

1. 1

   Introduction

   Family and Domestic violence are a common problem in the United States and affects approximately 10 million people every year. They are abusive behaviors in which one individual gains power over another individual. Domestic and family violence occurs in all ages, races, and sexes. It knows no cultur

   4 min

2. 2

   Causes of Child Abuse

   Child abuse often starts when a caretaker or parent feels the need to dominate or control a child (Rooney, et.al, 2018). This can occur because of several reasons, such as:

   5 min

3. 3

   Statistical Data

   At least 14% of children have experienced child abuse and/or neglect in the past year, and due to barriers/lack of reporting, this is likely an underestimate. Rates of child abuse and neglect are five times higher for children in families with low socio-economic status compared to children in famili

   4 min

4. 4

   Federal Child Abuse Prevention and Treatment Act (CAPTA)

   Each state has specific child abuse statues. Federal legislation provides guidelines for defining acts that constitute child abuse. The guidelines suggest that child abuse includes an act or failure to act that presents an imminent risk of serious harm. This includes any recent act or failure to act

   4 min

5. 5

   Title 55-Chapter 3490 Child Protections

   Pennsylvania defines child abuse under 3490.4. The term child abuse means any of the following (55 Pa. Code Chapter 3490, 2022):

   4 min

6. 6

   Pennsylvania Act 31 of 2014

   Act 31 requires that anyone applying for an initial license or certificate from any of the health-related boards (except the State Board of Veterinary Medicine) or from the State Board of Funeral Directors must complete three hours of continuing education on child abuse recognition and reporting (Ac

   4 min

7. 7

   Pennsylvania Act 54 of 2018

   The federal Child Abuse Prevention and Treatment Act (CAPTA) authorizes funding for state grants when a state has “policies and procedures” ensuring that health care providers refer infants that are identified as affected by substance abuse, experience withdrawal symptoms or have Fetal Alcohol Spect

   4 min

8. 8

   Plan of Safe Care

   After notification of a child born affected by substance use or withdrawal symptoms resulting from prenatal drug exposure or a fetal alcohol spectrum disorder:

   4 min

9. 9

   Penalties for Failure to Report

   A mandated reporter who willfully fails to report suspected child abuse or to make a referral to the appropriate authorities, commits an offense.

   4 min

10. 10

    Making the Report

    In Pennsylvania there is a distinction between child protective services (services and activities provided by the department and each county agency for child abuse cases) and general protective services (services and activities provided for non-abuse cases where intervention and support may help to

    5 min

11. 11

    Child Abuse

    Identifying a child of suspected abuse is difficult because the child may be nonverbal or too frightened or severely injured to talk. Also, the perpetrator will rarely admit to the injury, and witnesses are uncommon. Healthcare providers will see children of abuse in a range of ways that include:

    4 min

12. 12

    Types of Abuse Seen in Children

    Abusive Head Trauma:

    7 min

13. 13

    Special Considerations

    When feasible, and without delaying care to the child, photographs of injuries should be taken prior to initiating treatment of suspected injuries of child abuse.

    4 min

14. 14

    Glasgow Coma Scale (GCS)

    The pediatric GCS is like the adult GCS, but the main difference is in the verbal response assessment. It has also been modified to address age-appropriate responses within the pediatric population. For instance, the pediatric GCS assigns a normal verbal score of 5 for babbling, cooing, or being ori

    4 min

15. 15

    Laboratory Testing for Suspected Child Abuse

    Laboratory studies are often important for forensic evaluation and criminal prosecution. On occasion, certain diseases may mimic findings that are like child abuse (Singhi & Kumar, 2016), and therefore, they must be ruled out.

    4 min

16. 16

    Diagnostic Imaging for Suspected Child Abuse

    The evaluation of the pediatric skeleton can prove challenging for a non-specialist as there are subtle differences from adults and children, such as cranial sutures and incomplete bone growth. As a result, a fracture can be misinterpreted (Mucha, DeWitt, Greenspan, 2019). When child abuse is suspec

    4 min

17. 17

    Treatment of Abusive Head Trauma

    Initial management of an abused child involves stabilization, including assessing the child’s airway, breathing, and circulation (Araki, Yokota, Morita, 2017). Airway adjuncts should be used in a child who is not able to maintain an open airway or maintain an oxygen saturation greater than 90% with

    4 min

18. 18

    Conclusion

    Child abuse is a public health problem that leads to lifelong health consequences, both physically and psychologically. Physically, children who are victims of abusive head trauma may have neurologic deficits, developmental delays, cerebral palsy, and other forms of disability. Psychologically, vict

    4 min

19. 19

    Scenarios

    Shawn is 8 years old and just arrived back at school after a weeklong vacation with his mother and stepfather. His physical education teacher notices him limping on his left leg and refusing to participate in any activity. When asking him if his leg hurt, he shakes his head “no” and refuses to answe

    4 min

20. 20

    Child-Help USA

    Treatment programs such as Child-help Group Homes and Child-help Advocacy centers have been designed to help children who are suffering from child abuse. There are also prevention programs, including Child-help Speak Up Be Safe for Educators.

    4 min

21. 21

    Child Abuse and Pediatric Head Trauma Posttest

    Prepubescent children who are victims of sexual violence do not routinely receive prophylactic treatment for sexually transmitted infections.

    4 min

22. 22

    Child Abuse and Pediatric Head Trauma Posttest Answers

    …The second most common type of child abuse after neglect is physical abuse.

    13 min

This course satisfies

Requirement summaries come from our state requirement records. Always confirm details with your board before you renew.

References and resources

• NA; (2012). Guidelines for the acute medical management of severe traumatic brain injury in infants, children, and adolescents-second edition. Pediatric Critical Care Medicine, 13, S1-S2. https://doi.org/10.1097/pcc.0b013e31823f435c
• Adelson, P. D., Wisniewski, S. R., Beca, J., Brown, S. D., Bell, M., Muizelaar, J. P., Okada, P., Beers, S. R., Balasubramani, G. K., & Hirtz, D. (2013). Comparison of hypothermia and normothermia after severe traumatic brain injury in children (Cool kids): A phase 3, randomized controlled trial. The Lancet Neurology, 12(6), 546-553. https://doi.org/10.1016/s1474-4422(13)70077-2
• Araki, T. Yokota, H. & Morita, A. (2017). Pediatric traumatic brain injury: Characteristic features, diagnosis, and management. Neurologia medico-chirurgica, 57(2), 82-93. https://doi.org/10.2176/nmc.ra.2016-0191
• Beaver, K. M. (2017). The interaction between genetic risk and childhood sexual abuse in the prediction of adolescent violent behavior. Biosocial Theories of Crime, 235-252. https://doi.org/10.4324/9781315096278-10
• Chen, C., Peng, J., Sribnick, E., Zhu, M., & Xiang, H. (2018). Trend of age-adjusted rates of pediatric traumatic brain injury in U.S. emergency departments from 2006 to 2013. International Journal of Environmental Research and Public Health, 15(6), 1171. https://doi.org/10.3390/ijerph15061171
• Guerrero, M. (2017). Accuracy of PECARN, CATCH, and chalice head injury decision rules in children: A prospective cohort study. The Journal of Emergency Medicine, 53(1), 155-156. https://doi.org/10.1016/j.jemermed.2017.05.015
• Litz, C. N., Ciesla, D. J., Danielson, P. D., & Chandler, N. M. (2017). A closer look at non-accidental trauma: Caregiver assault compared to non-caregiver assault. Journal of Pediatric Surgery, 52(4), 625-627. https://doi.org/10.1016/j.jpedsurg.2016.08.026
• Mucha, A., DeWitt, J., & Greenspan, A. I. (2019). The CDC guideline on the diagnosis and management of mild traumatic brain injury among children: What physical therapists need to know. Physical Therapy, 99(10), 1278-1280. https://doi.org/10.1093/ptj/pzz085
• Rooney, E. E., Hill, R. M., Oosterhoff, B., & Kaplow, J. (2018). Violent victimization and perpetration as distinct risk factors for adolescent suicide attempts. https://doi.org/10.31234/osf.io/cgmqv
• Singhi, S., & Kumar, R. (2016). Raised intracranial pressure in children with an acute brain injury: Monitoring and management. Critical Care, 406-406. https://doi.org/10.5005/jp/books/12670_49
• Stockman, J. (2011). Identification of children at very low risk of clinically important brain injuries after head trauma: A prospective cohort study. Yearbook of Pediatrics, 2011, 392-395. https://doi.org/10.1016/s0084-3954(10)79686-x
• Taylor-Robinson, D. C., Straatmann, V. S., & Whitehead, M. (2018). Adverse childhood experiences or adverse childhood socioeconomic conditions? The Lancet Public Health, 3(6), e262-e263. https://doi.org/10.1016/s2468-2667(18)30094-x
• 55 Pa. Code Chapter 3490. Protective services. (n.d.). Pennsylvania Code & Bulletin. https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/055/chapter3490/chap3490toc.html
• Act 31. (n.d.). Pennsylvania Department of State. https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Pages/Act-31.aspx
• Mandated reporter frequently asked questions. (n.d.). Department of Human Services. https://www.dhs.pa.gov/KeepKidsSafe/Clearances/Documents/FAQ_Mandated%20Reporter.pdf

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