session six: the impact of neglect, physical, emotional, & sexual abuse on permanency this...

Session Six: The Impact of Neglect,

Physical, Emotional, & Sexual Abuse on Permanency

Session Six: The Impact of Neglect, Physical, Emotional, & Sexual Abuse on Permanency

This session will review the negative impact of neglect and abuse (physical, emotional, and sexual) on children, youth, and families. Students will compare normative childhood development and its tasks with childhood development clouded by abuse, neglect, and the trauma associated with those conditions. The class will learn about the role of psychopharmacological interventions and the healing power of relationships.

Session Six Competencies Knows and understands the impact of abuse/neglect; substance abuse; domestic violence; mental illness and poverty of families and communities on children, youth and families affected by the child welfare system.

Session Six Objectives

Explain the State’s legal definition of physical abuse, sexual abuse, neglect, dependency and endangerment. Describe the physical, emotional, and behavioral indicators of physical abuse, neglect and sexual abuse in child victims and their families. Describe the unique interpersonal and family dynamics typically associated with physical and sexual abuse, neglect, and emotional maltreatment. Identify risk and protective factors in family functioning.

Child Neglect - DefinitionThe inability or unwillingness of a parent, guardianor custodian of a child to provide that child with supervision, food, clothing, shelter or medical care if that inability or unwillingness causes unreasonable risk of harm to the child's health or welfare, except if the inability of a parent, guardian or custodian to provide services to meet the needs of a child with a disability or chronic illness is solely the result of the unavailability of reasonable services.

Child Neglect - Definition

Permitting a child to enter or remain in any structure or vehicle in which volatile, toxic

or flammable chemicals are found or

equipment is possessed by any person for the purposes of manufacturing a dangerous drug.

Child Neglect - DefinitionA determination by a health professional that a newborn infant was exposed prenatally to a drug or substance and that this exposure was not the result of a medical treatment administered to the mother or the newborn infant by a health professional. This subdivision does not expand a health professional’s duty to report neglect based on prenatal exposure to a drug or substance.

Child Neglect - DefinitionThe determination by the health professional shall be based on one or more of the following:

Clinical indicators in the prenatal period including maternal and newborn presentation.

History of substance use or abuse.

Medical history.

Results of a toxicology or other laboratory test on the mother or the newborn infant.

Child Neglect - DefinitionDiagnosis by a health professional of an

infant under one year of age with clinical findings consistent with fetal alcohol syndrome or fetal alcohol effects.

Deliberate exposure of a child by a parent, guardian or custodian to sexual conduct or to sexual contact, oral sexual contact or sexual intercourse or explicit sexual materials.

Child Neglect - DefinitionAny of the following acts committed by the

child’s parent, guardian or custodian with reckless disregard as to whether the child is physically present:Sexual contactOral sexual contact Sexual intercourseBestiality

Child NeglectImpact on Permanency

Defining neglect historically has been difficult to do, leading to inconsistencies in policies, practice andresearch.

Without a consistent definition of neglect, it is nearly impossible to compare research results.

This inconsistency also leads.to.variability.in.the.way. Neglect cases are handled.


The debate over a definition of neglect centers on a lack of consensus in answering these questions:

• What are the minimum requirements associated with caring for a child? • What action or inaction by a parent or other caregiver constitutes neglectful behavior?


• Must the parent’s or caregiver’s action or inaction be intentional? • What impact does the action or inaction have on the health, safety, and well-being of the child?

• What consititutes failure or inability to provide, food, shelter, protetcion or clothing?


• Should failure to thrive be included?

• Is action or inaction the result of poverty rather than neglect?


Neglected children, even when older, may display a variety of emotional, psychosocial, and behavioral problems which may vary depending on the age of the child Some of these include: • Displaying an inability to control emotions or impulses,

usually characterized by frequent outbursts; • • Being quiet and submissive;


• Having difficulty learning in school and getting along with siblings or classmates;

• Experiencing unusual eating or sleeping behaviors; • Attempting to provoke fights or solicit sexual interactions; • Acting socially or emotionally inappropriate for their age; • Being unresponsive to affection; • Displaying apathy; • Abusing alcohol or drugs


• Being less flexible, persistent, and enthusiastic than non-neglected

children;

• Demonstrating helplessness under stress; • Having fewer interactions with peers than non-neglected children; • Displaying poor coping skills; • Acting highly dependent; • Acting lethargic and lack luster; • Displaying self-abusive behavior (eg,suicide attempts or cutting

themselves);


• Exhibiting panic or dissociative disorders, attention-

deficit/hyperactivity disorder, or post-traumatic stress disorder;

• Suffering from depression, anxiety, or low self-esteem; • Exhibiting juvenile delinquent behavior or engaging in

adult criminal activities; • Engaging in sexual activities leading to teen pregnancy or

fatherhood; • Having low academic achievement;

Child NeglectFamily Factors

Several family characteristics are associated with higher rates of neglect.

Some life situations, such as:

Marital Problems,Domestic Violence, Single Parenthood, Unemployment, Financial Stress

All can increase the likelihood that neglect will occur.

Child NeglectFamily Factors

Although these characteristics may not cause maltreatment, they are possible risk factors for neglect Some family characteristics that may lead to neglect can be categorized as:

• Communication and Interaction Patterns, Family composition, Domestic ViolenceFamily Stress

Severity of Child Neglect Mild NeglectUsually does not warrant a report to CPS, but might necessitate a community-based intervention( eg, a parent failing to put the child in a car safety seat) Moderate NeglectOccurs when less intrusive measures, such as community interventions, have failed or some moderate harm to the child has occurred (eg, a child consistently is inappropriately dressed for the weather, such as being in shorts and sandals in the middle of winter) For moderate neglect, CPS may be involved in partnership with community support Severe NeglectOccurs when severe or long-term harm has been done to the child (eg, a child with asthma who has not received appropriate medications over a long period of time and is frequently admitted to the hospital) In these cases, CPS should be and is usually involved, as is the legal system

Types Child Neglect PhysicalMedicalInadequate SupervisionEnvironmentalEducationalEmotionalNewborns Addicted or Exposed to Substances

Child Abuse - DefinitionPhysical, sexual or emotional maltreatment or neglect of a child or children. In the United

States, the Centers for Disease Control and Prevention (CDC) and the Department for Children and Families (DCF) define child maltreatment as any

act or series of acts of commission or omission by a parent or other caregiver that results in harm, potential for harm, or threat of harm to a child.

https://en.wikipedia.org/wiki/Centers_for_Disease_Control_and_Prevention

Child Abuse - Definition

Child abuse can occur in a child's home, or in the

organizations, schools or communities the child interacts with. There are three major

categories of child abuse: physical abuse, emotional abuse,

and sexual abuse.

Child Abuse - PhysicalNon-accidental physical injury (ranging

from minor bruises to severe fractures or death) as a

result of punching, beating, kicking, biting, shaking, throwing, stabbing, choking, hitting (with a

hand, stick, strap, or other object), burning, or

otherwise harming a child, that is inflicted by a

parent, caregiver, or other person who has

responsibility for the child, regardless the intention.

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BRUISES, CUTS, WELTS, OR SCRATCHES

BRUISES CUTS WELTS SCRATCHES*Discolored but not broken*Contusions*Old- yellow, green, or brown*New- red, purple, or blue*Fade–from outer edges inward

*Minor opening, incision or break caused by external agent

*Elevation of the skin caused by lash or blow; *Usually a belt, electrical cord or wire hanger;*Skin is not broken

*Thin, shallow opening, mark or break in the skin;*Usually from a sharp object or fingernails

Child Abuse - EmotionalA pattern of behavior that impairs a child’s emotional development or sense of self-worth. This may include constant criticism, threats, or rejection, as well as withholding love, support, or guidance. It is often difficult to prove, and therefore, child protective services may not be able to intervene without evidence of harm or mental injury to the child. Emotional abuse is almost always present

when other types of maltreatment are identified.

Life Time Consequences of Maltreatment

School achievement and drop out ratesEmploymentLong-term medical effectsCriminal behaviorSubstance abuseRelationship dysfunctionPartner violencePromiscuity/prostitution and high risk sexual

behaviorsTeen pregnancy

Life Time Consequences of Maltreatment

Sexual victimization as an adultPanic and anxiety disordersDepressionSerious mental illnessBipolar disorderSuicidal behaviorPersonality disordersHomelessnessVictimization of othersResilience

ACE StudyLife Time Consequences of Maltreatment

Children living in adverse circumstances with known family/caregiver risk factors are at higher risk for adverse outcomes, and maltreatment compounds the negative outcomes. • Maltreatment reports appear more likely in households where mothers are depressed, complain of somatic symptoms, consume alcohol, participate in public income support programs, care for more than one dependent child, have not graduated from high school, or were separated from their own mothers by age 14. • In general, families with low levels of social support have a higher risk of a maltreatment report.


• Most children who were victimized were victims of more than one type of maltreatment. • CPS classification of general neglect was the best predictor of child behavior problems and poor socialization. • Type of abuse, severity, chronicity, and age of onset impact social, emotional, and behavioral problems. For example, child neglect in the first two years of life appears to be a more important precursor of childhood aggression than either later neglect or physical abuse at any age


• It is important to know about the pattern of a child’s maltreatment experience over and above a simple count of substantiations or allegations. Both the extent and the continuity of a child’s maltreatment predict social, emotional, and behavioral outcomes. • The link between intimate partner violence and child maltreatment is very strong.

Child Abuse - Sexual

Activities by a parent or caregiver such as fondling a

child’s genitals, penetration, incest, rape, sodomy,

indecent exposure, and exploitation through prostitution or the production of pornographic materials.


Federal Statute Child sexual abuse is defined in Federal law

by the Child Abuse Prevention and Treatment Act,

CAPTA (42 U.S.C. sec. 5106g(4)).

Child Abuse - SexualIt is defined by CAPTA as “the employment, use, persuasion, inducement, enticement, or coercion of any child to engage in, or assist any other person to engage in , any sexually explicit conduct or simulation of such conduct for the purpose of producing a visual depiction of such conduct; or the rape, and in cases of caretaker or inter-familial relationships, statutory rape, molestation, prostitution, or other form of sexual exploitation of children, or incest with children.”

Child Abuse - SexualLouisiana Definition - Sexual Abuse/Exploitation Citation: Ch. Code art. 603 The term 'abuse' includes any one of the following acts that seriously endanger the physical, mental, or emotional health of the child: The involvement of the child in any sexual act with a

parent or any other person The aiding or toleration by the parent or caregiver of

the child's sexual involvement with any other person The aiding or toleration by the parent of the child's

involvement in pornographic displays

Child Abuse - SexualAny other involvement of a child in sexual activity

constituting a crime under the laws of the State 'Child pornography' means visual depiction of a

child engaged in actual or simulated sexual intercourse, deviate sexual intercourse, sexual bestiality, masturbation, sadomasochistic abuse, or lewd exhibition of the genitals.

A 'crime against a child' includes rape, sexual battery, incest, carnal knowledge of a juvenile, indecent behavior with a juvenile, pornography involving juveniles, a crime against nature, or molestation of a juvenile.

Child Abuse - SexualConsider the possibility of sexual abuse

when the child shows these signs: 1. Has difficulty walking or sitting2. Suddenly refuses to change for gym or to

participate in physical activities 3. Reports nightmares or bedwetting4. Experiences a sudden change in appetite

Child Abuse - Sexual5. Demonstrates bizarre, sophisticated, or unusual

sexual knowledge or behavior 6. Becomes pregnant or contracts a venereal

disease, particularly if under age 14 7. Runs away 8. Reports sexual abuse by a parent or another

adult caregiver 9. Attaches very quickly to strangers or new

adults in their environment

Child Abuse - SexualConsider the possibility of sexual abuse when

the parent or other adult caregiver is: 1. Unduly protective of the child or severely

limits the child’s contact with other children, especially of the opposite sex

2. Secretive and isolated 3. Jealous or controlling with family members

Child Abuse - SexualStandardized measures completed either by the child or the caregiver are: Child Sexual Behavior Inventory (CSBI)-

caregiverChild Behavior Checklist (CBCL) - caregiverTrauma Symptom Checklist for Children

(TSCC) – child (age 8 and older)Trauma Symptom Checklist for Young

Children (TSCYC) - caregiver

Child Abuse - SexualIn general children do not falsely assert they have

been sexually abused.They are unlikely to have an interest in making a false allegation. Being a victim of sexual abuse is associated with shame, stigma, and stressful interventions like talking to the police, having to be involved in a forensic interview, being removed from the home, and having to testify in court.


Criteria to look for in a true allegation: - Description of an explicit sexual act. - Not just he/she hurt me, touched me. - A description of the sexual abuse that

reflects a child’s perspective.

Child Abuse - Sexual- Details about the abuse:

Such as what the offender’s penis looked like Where the penis went What the abuse felt like How long the sexual act went on Whether anything came out of the penisIf so, what color it was or what it tasted like What happened to the stuff that came out of

the penis.

Child Abuse - Sexual- Details about the context of the sexual

abuse:Where it happened--in a house,

apartment, trailer, etc., what room, where in the room, a description of the room.

When (within the child’s time sense) it happened.

Where other people were.

Child Abuse - Sexual- Other details about the context of the

sexual abuse: What the offender said to get the child

involved.Whether the offender said anything

about telling or not telling.What clothing was worn and taken off.

Child Abuse - SexualResearch tells us that: Almost every report of sexual abuse leads to a counter-concern that the allegation might be false.Failure to report actual sexual abuse is a much larger problem than falsely reporting sexual abuse.

Child Abuse - SexualBetween one-fourth and one-third of children

deny sexual abuse during forensic interviews.Populations where there are other indicators

of sexual abuse have higher rates of non-disclosure.Research indicates that more than half of

children with Sexually Transmitted Infections do not disclosure sexual abuse when asked.

Research indicates that a half to a third of children for whom there was video evidence of sexual abuse did not disclose when interviewed.


Research tells us that: Most false reports come from adults, not

childrenMost false reports are misinterpretations.Calculated false allegations of sexual abuse

are rare.Research indicates they are more likely to

be made by non-custodial parents than custodial parents.

Child Abuse - SexualCHILD WELFARE WORKERS’

RESPONSIBILITIES:

Inform foster/adoptive parents about the abuse history and behavior problems of each child on your caseload.

Help the family develop the rules.Help the family decide on an appropriate

sexual abuse prevention training.


Facilitate family meetings as indicated. Ask the foster/adoptive parents to make notes

from each family meeting.Review the notes and monitor family

meetings. Assure the treatment the child receives is

evidence-based.

Child Abuse - SexualADVICE FOR CHILD WELFARE WORKERS:

Don’t just refer the child to “counseling”.Child welfare workers need to be sure the

treatment provided to children on their caseloads is evidence-based and trauma informed treatment for sexual abuse.


Children in care do not live in a vacuum; their caregivers must be involved in their treatment.

Caregivers need counseling, too; parenting sexually abused children is very, very challenging.

Seek out therapists who provide individual treatment for children and caregivers and family sessions


What Can You Do?

PROTECT YOUR CHILDREN SUPPORT CHILD ABUSE VICTIMS TEACH OTHERS ABOUT CHILD ABUSE REPORT, REPORT, REPORT


The effects of sexual abuse extend far beyond

childhood. Sexual abuse robs children of

Their childhood and creates a loss of trust,

feelings of guilt and self-abusive behavior.


It can lead to antisocial behavior, depression,

identity confusion, loss of self-esteem and other serious emotional problems.


It can also lead to difficulty with intimate

relationships later in life. The sexualvictimization of children is ethically and morally wrong.

Child Sexual AbuseImpact on Permanency

It can also lead to difficulty with intimate

relationships later in life. The sexualvictimization of children is ethically and morally wrong.

session six: the impact of neglect, physical, emotional, & sexual abuse on permanency this...

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