Child Abuse

Risk Identification
&
Mandated Reporting

Why We Have a Law

Protect children
Identify and assist
troubled families
Spur change
Benefit community
The California Child
Abuse and Neglect
Reporting Law is
currently found in Penal
Code (P.C.) Sections
11164 - 11174.3

What is Child Abuse?

Willful harming or injuring of a child or the
endangering of the person or health of a
child.
Penal Code 11165.3

Types of Abuse

Physical Abuse (P.C. 11165.6)

Sexual Abuse (P.C. 11165.1)

Involvement of dependent, developmentally immature children and

adolescents in sexual activities which they do not fully comprehend
and to which they are unable to give informed consent. Sexual
abuse includes touching, fondling and penetration, as well as
exploitation.

Neglect (P.C. 11165.2)

Nonaccidental physical injury as a result of caretaker acts. Physical

abuse frequently includes shaking, slapping, punching, beating,
kicking, biting and burning.

Failure of caretakers to provide for a childs fundamental needs.

Although neglect can include childrens necessary emotional needs,
neglect typically concerns adequate food, housing, clothing, medical
care and education.

Emotional / Psychological Abuse (P.C. 11166.05; P.C. 11165.4)

The habitual verbal harassment of a child by disparagement,

criticism, threat and ridicule. Emotional or psychological abuse
includes behavior that threatens or intimidates a child. It includes
threats, name calling, belittling and shaming.

Categories of Abuse
Neglect
General
Severe
Physical abuse
Unlawful corporal
punishment
Injury
Sexual abuse
Sexual assault
Sexual Exploitation
Emotional Abuse
Mental Suffering
Emotional Maltreatment

What is Neglect?
General:

Severe:

Failing to provide adequate food,

shelter, medical care or
supervision, where no physical
injury has occurred

Failure of a caregiver to provide

adequate food, clothing, shelter, or
medical care.

The child is placed in a situation in which its health is

endangered, including intentional failure to provide
adequate food, clothing, shelter or medical care.

Red Flags for possible neglect

Child Factors

Socially withdrawn
Dirty clothes, clothes inappropriate for
weather, poor hygiene
Failure to thrive, or a malnourished
child
Untreated medical problems/illness
Severe dental cavities
Developmental delay
Self-abusive behaviors
Behavioral problems such as anxiety
or aggression

Red Flags for possible neglect

Parent Factors

Depression
Domestic violence
Unemployment
Poverty
Lack of social support
Mental illness or mood disturbances
History of abuse a child
Substance abuse

Red Flags for possible neglect

Home Environment

Medications, cleaners, toxins within reach

of a child
Guns or other weapons that are not
properly secured
Trash, rotted food, insects, or animal
waste
Choking hazards within reach of an infant
or toddler
Hazardous conditions (broken windows,
faulty electrical fixtures, etc.)
Health risks (infestation, no running water,
no heat, unsanitary conditions, etc.)

Homelessness

Homelessness is not in and of itself a

reportable condition

Report must be made in specific

instances of physical abuse, neglect,
sexual abuse, or emotional abuse

Intervention priority is to provide

necessary shelter, food, education,
and other services

If parent is unable to provide for basic

needs such as food, warmth, medical
care, etc., and an unsafe situation is
created, situation may meet the
criteria for reportable neglect.

Kaitlyns Law
Unattended Child in Motor Vehicle Act

Child who is 6 years of

age or younger may not
be left inside an motor
vehicle unattended
(not part of Mandated
Reporter Law)

What is Physical Abuse?

Non-accidental physical injury

Accidental injuries may fall under neglect, however.

Willful cruelty
Unjustifiable punishment

Unreasonable or extreme patterns of discipline that

result in emotional distress or suffering

Does not include a mutual affray between

minors

If the fight isnt mutual (i.e. bullying w/a passive

victim, its reportable even if the perpetrator is a
minor)
This includes domestic violence between teens

Unlawful corporal punishment

Law defines lawful punishment as reasonable and

age appropriate

Signs of Physical Abuse

The type, location, and pattern of injuries such as bruises or

burns can help distinguish accidental injuries from suspected
physical abuse.

Any injury, even a small bruise in a young infant is concerning

If a child is unable to roll over or crawl, they are unable to sustain injuries on their own

Typical locations for accidental bruises in toddlers and children

include bony areas such as shins, elbows, knees, forehead, and chin
among others.

In contrast, common locations of abusive injuries include the back,

buttocks, ears, face (particularly the soft tissues of the cheek), neck,
and genitalia.

Abusive bruises and burns may be patterned, or have a distinct

outline. Accidental bruises typically do not leave a clear pattern
or outline.

Location of Injuries
Normal or Accidental
Bruising
Forehead
Head
Chin
Knees
Elbows
Outer arms
Shins

Abnormal or
Suspicious Bruising
Cheeks of the face
Buttocks
Ears
Neck
Back
Genitals

Injury Examples

Click on the links below to see examples of

physical injuries related to child abuse.
WARNING: graphic content.
Slap

Injury

Object

Burn

Injury

Injury

Injury Red Flags

Broken bones, lacerations, unexplained bruises

Burns (cigarette, scalding water, iron)
A parent or caretaker who delays or fails to seek medical
care for the child's injury
Any unexplained injury/injury with an
improbable explanation
Patterns of bruising or fractures in different stages of
healing (indicating trauma over time)
A history of previous or recurrent injuries
A statement by the child that the injury was caused by
abuse
An injury that is unusual for the child's age

Red Flags for Physical Abuse

Parental Behaviors

Parental depression or other mental illness

Parent tells you of use of objects (belts, whips,
clothes hanger) to discipline the child
Parent has unrealistic expectation of child (e.g.,
toilet-training a 6-month-old)
Parent is unduly harsh and rigid about childrearing
Parent singles out one child as "bad," "evil," or
"beyond control."
Parent berates, humiliates, or belittles child
Parent misinterprets child's normal behavior (e.g., a
parent interprets an infant's crying as evidence that
child hates the parent)
Parent is indifferent to child

Red Flags for Physical Abuse

Child Behavior

Poor anger management; hostile, aggressive, or

verbally abusive toward others (most common
symptom)
Fearful or withdrawn behavior, wariness of adults
Self-destructive (self-mutilates, bangs head, etc.)
Destructive (breaks windows, sets fires, etc.)
Discomfort when other children cry
Frightened of going home, frightened of
parents/caretakers
Attempts to hide injuries
Frequent absence from school
Clingy, forms indiscriminate attachments

What is Sexual Abuse?

Sexual Assault/Abuse

Rape
Rape in concert
Incest
Sodomy
Oral copulation
Penetration by a foreign
object
Child molestation
Lewd and lascivious
behavior
Unlawful sexual
intercourse
Masturbating in the
presence of a child (P.C.
11165.1[b])

Sexual Exploitation

Child pornography (development

or distribution)

1/15/15 the law was altered to

include anyone who downloads,
streams, or accesses through any
electronic or digital media, or
exchanges, a film, photograph,
videotape... in which a child is
engaged in an act of obscene
sexual conduct."

Employment in sex acts

Sexual Abuse Reporting

Nonconsensual sexual activity is always

reported, regardless of age.

While a child may disclose that the activity was consensual,

if the reporter has a reasonable suspicion of coercion, or
feels that the child has limited ability to consent (for
example, if the child has limited cognitive capacity) they may
determine that consent did not, in fact, exist.

Pregnancy or STI is not enough, in and of itself, to

justify a sexual abuse report
Consensual sexual activity may be reportable based
in the nature of the activity or age differences.

Consensual activity between two children who are under 14

is not reported.
Reporting consensual sex based on age is somewhat
complicated:

Normal, Common
Behaviors
Touching/masturbating
genitals in public/private
Viewing/touching peer or
new sibling genitals
Showing genitals to peers
Standing/sitting too close
Trying to view peer/adult
nudity
Behaviors are transient,
few, and distractable

Less Common Normal Uncommon Behaviors

Behaviorsa
in Normal Childrenb
Rubbing body against
others
Trying to insert tongue in
mouth while kissing
Touching peer/adult
genitals
Crude mimicking of
movements associated with
sexual acts
Sexual behaviors that are
occasionally, but
persistently, disruptive to
others
Behaviors are transient
and moderately responsive
to distraction

Asking peer/adult to
engage in specific sexual
act(s)
Inserting objects into
genitals
Explicitly imitating
intercourse
Touching animal genitals
Sexual behaviors that are
frequently disruptive to
others
Behaviors are persistent
and resistant to parental
distraction

Rarely Normalc
Any sexual behaviors that
involve children who are 4
or more years apart
A variety of sexual
behaviors displayed on a
daily basis
Sexual behavior that
results in emotional distress
or physical pain
Sexual behaviors
associated with other
physically aggressive
behavior
Sexual behaviors that
involve coercion
Behaviors are persistent
and child becomes angry if
distracted

Normative Sexual Behavior, Ages 2-6

Some sexual activity in children may raise suspicion of abuse, even if
the behavior appears voluntary of consensual.
Kellogg (2009). American Academy of Pediatrics
http://pediatrics.aappublications.org/content/124/3/992.full.html

Consensual Sex - Report by Age

KEY: M = Mandated. A report is mandated based solely on age difference
between partner and patient. CJ = Clinical Judgment. A report is not mandated
based solely on age; however, a reporter must use clinical judgment and must
report if he or she has a reasonable suspicion that act was coerced, as
described above.

Red Flags Child behaviors concerning for

possible sexual abuse

Child disclosure

Very common for children to disclose well after the fact,

or to recant following disclosure

Inappropriate sexual knowledge for age

Demonstrating sexual acts on other children or
toys
Coercing, manipulating, or forcing other children
into sexual activity
Obsessive Cleanliness
Sexually transmitted infections

What is Emotional Abuse?

Any act which results in
mental suffering, or when a
childs emotional well-being
is endangered.

Verbal assaults: belittling, threats, blaming, screaming, sarcasm

Unpredictable responses
Continual negative mood
Family discord / domestic violence
Confinement
Use of extreme/bizarre forms of punishment
Emotional deprivation / neglect: ignoring, withholding touch or
affection, rejecting, isolating

Distinguishing Emotional Abuse from

Children with Emotional Problems

Emotional
Disturbance
Parent

recognizes
the existence of a
problem

Show

concern for
the childs welfare,
actively seek help

Emotional Abuse
Blames

the child or
ignores existence of
the problem
Refuse offers of
help, appear
punitive and
unconcerned for
childs welfare

Red Flags Emotional Abuse

Child Behaviors

Frightened of going home,

frightened of
parents/caretakers

Clingy, may form indiscriminate

attachments to unrelated adults

Developmental delay

Self-abusive behaviors

Socially withdrawn

Behavioral problems such as

anxiety or aggression

Parental Behaviors

Parental depression or other

mental illness

Parent has unrealistic

expectation of child (e.g., toilettraining a 6-month-old)

Parent is unduly harsh and

rigid about childrearing

Parent singles out one child as

"bad," "evil," or "beyond
control.

Parent berates, humiliates, or

belittles child

Parent is indifferent to child

Domestic Violence Exposure

Domestic Violence exposure is often reported

under the category of emotional abuse
40-60%

of children in household with Domestic

Violence are also physically abused

In the context of domestic violence, a

mandated reporter must consider whether
there is a risk of physical or emotional harm
to the child.
The

presence of DV is not in and of itself

sufficient for abuse reporting.

Domestic Violence Exposure

Serious emotional damage (SED) in the

context of child protection laws means the
child exhibits any of the following:
Severe

Anxiety
Depression
Withdrawal
Aggressive behavior toward self or others, as the
result of the conduct of a parent.

Domestic Violence Exposure

Young children (0-5) are at the greatest risk for

traumatization from witnessing violence towards
their primary caregiver (typically their mother).

They are less likely to recognize other forms of

danger as threatening

Was child placed at emotional or physical risk?

Factors to consider:

Were objects thrown or broken in the presence of the

child?
Did the perpetrator strike a victim who was holding a child
or did they hold the child while striking the victim?
Did the child physically intervene during the incident?

Domestic Violence Exposure

Did the perpetrator threaten to kill or to commit suicide?
Did the perpetrator threaten the victim with a gun, knife or
other weapon?
Did the perpetrator kick or bite or hit the victim with a fist?
Did the perpetrator hit or attempt to hit the victim with an
object?
Did the perpetrator choke or strangle the victim?
Did the perpetrator stalk the victim or the child?
Incidents which caused injury to the child or created a
serious risk of injury to the child are reportable.

A report may also need to be made if a victim of domestic violence

is (a) incapable of providing for the childs treatment or care for SED
caused by domestic violence; or (b) unable to protect the child from
repeated exposure to domestic violence even with the assistance of
community and child welfare services.

Responding and Reporting

Steps and Strategies

Disclosure
Children often avoid disclosure due to:
Developmental limitations
Lack of knowledge that the abuse was inappropriate
Pressure or threats from the perpetrator
Relationship to the perpetrator
Expected consequences of telling (e.g., physical
injury/death, family separation, parental distress)
Pressure from the childs family
Fear of negative reactions from parents or family
Fear of not being believed
Feelings of embarrassment, shame and self-blame; and/or
For males specifically: fears of stigmatization, being
labeled a victim or being labeled homosexual

Disclosure

As a result, disclosures are often:

Accidental
Indirect
Sometimes

uncle James keeps me up at night.

My babysitter keeps bothering me.
Disguised
I

have a friend at school who . . .

What would happen if a girl was being touched in a
bad way and she told someone about it?
Conditional
I

need to ask you about something, but you have to

promise not to tell.

Responding to a Childs Disclosure

The three things to tell a child following disclosure:

Im glad you told me. You did the right thing by telling me.

Its not your fault.

Im going to do everything I can to help keep you safe.

Avoid:

Interrogating. Ask few, open-ended questions necessary to make the report.

Expressing panic, anger, shock, or dismay.

Making negative statements about the alleged perpetrator (80% of perpetrators

are the childs parents).

Having the child repeat the explanation to different staff.

Do:

Create safety, get on the childs level, listen closely.

Valid the childs expressed feelings

Tell the child what youre going to do (dont promise not to tell anyone)

Two Types of Reporters

Mandated reporters those

required to report
suspected child abuse
Have legal duty to report
Can be held liable for
failure to report
Discretionary reporters
those who report simply
because they develop a
concern for a childs
welfare

Who Are Mandated Reporters?

People with regular contact with
children

Teachers (public or private schools)

Teachers aides/assistants
Any employee of a public or private
school
Employees of youth centers
Employees of day care centers
Foster parents

Others

Commercial film processors

Animal control officers
Clergy
CASA advocates

Who Are Mandated Reporters?

Health care personnel
Doctors,

dentists, nurses and all medical

personnel
Therapists, psychologists, social workers, mental
health workers

Public protection positions

Law

enforcement
Probation
Firefighters
Child welfare

When Should You Report?

If you know or reasonably suspect a child
has been the victim of child abuse or neglect,
you must report . . .
. . . while working in your professional capacity.
whenever a mandated reporter, in his or her
professional capacity or within the scope of his or her
employment, has knowledge or observes a child whom
the mandated reporter knows or reasonably suspects
has been the victim of child abuse or neglect.
(P.C. 11166(a))

Mandated Reporting Timeline

If the situation is an immediate emergency, CALL 911.

If you are under clinical supervision, the first thing you must
do is CONTACT YOUR SUPERVISOR. When you report you
are (legally) breaching confidentiality, so consult with your
supervisor.

Your initial report should be made by phone AS SOON AS

POSSIBLE:

Santa Barbara County CWS Hotline:

(800) 367-0166

Note the name of the CWS worker you report to.

Your written report should be filed within 36 hours (you can

fax or mail).

This form must be

used for your written
report, and can be
downloaded at:

http://caag.state.ca.us/
childabuse/pdf/ss_85
72.pdf

Liability and Immunity

A mandated reporter who fails to

make a required report of child
abuse is guilty of a misdemeanor
punishable by up to six months in
jail or by a $1,000 fine or by both
a fine and imprisonment. (P.C.
11166 (c))

A reporter who makes a report

within the law is immune from
both criminal and civil litigation.

And if a mandated reporter is sued

for making a report, he or she may
be able to receive compensation for
legal fees incurred in defending
against the action. (P.C. 11172 (c))

Safeguards for
Mandated Reporters
Safeguards
Identity kept confidential
Immune from civil and criminal liabilities
Immunity applies 24/7, though mandated
reporters are compelled to report only in the
scope of their employment or within their
professional capacity
Does not prevent lawsuits
Reimbursement costs P.C. 11172 (c)

Thank You!

References

Adapted from:
Zulliger, K. (2009) Mandated Reporting for Child Abuse and
Neglect. Presentation to Santa Barbara County Child Abuse
Prevention Council, August 18, 2009
California Department of Social Services (2011). Child Abuse
Mandated Reporter Training.
http://www.mandatedreporterca.com/default.htm
Additional References:
National Child Traumatic Stress Network (2010). Sexual
Development and Behavior in Children.
http://www.hss.state.ak.us/ocs/Publications/pdf/sexualdevelopchildren.pdf
Gil, E. & McCullouch, L. (2010). Child Abuse and Neglect
Reporting Law. Issues and Answers for Mandated Reporters.
Chadwick Childrens Center, Rady Childrens Hospital, San Diego.
http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&c
d=3&cad=rja&ved=0CCsQFjAC&url=http%3A%2F%2Fwww.mand
atedreporterca.com%2Fimages%2FPub132.pdf&ei=TahmUNn2H4
GC2wXkqYCADA&usg=AFQjCNHQuVrn6ExstLqg_kRKp5I3gnaKA&sig2=HMSNUy7rwIEJJ4ysYVeAQ