Know

As a support staff member, your job includes doing your best to make the program a great place for you, your coworkers, and the children and families served. Because the children in your center depend on adults for their safety, this also means you must do your best every day to keep children safe. For this, you must be able to recognize when a child is in harm’s way.

The threat of abuse or neglect can be present at home, at school, or in child care programs. Because of this, children should be surrounded by a network of caring adults who are aware of the signs of abuse and neglect and will quickly respond to help the child. Look for the following signs from the Child Welfare Information Gateway's fact sheet on What Is Child Abuse and Neglect? Recognizing the Signs and Symptoms. 

The child:

• Shows sudden changes in behavior, changes that seem like regression (losing skills they once had, crying more, etc.) or changes in school performance
• Has not received help for physical or medical problems brought to the parents’ attention
• Is always watchful, as though preparing for something bad to happen
• Lacks adult supervision
• Is overly compliant, passive, or withdrawn (doesn’t respond to situations that seem to warrant a response)
• Has little reaction to parents at pickup or drop off
• Is dropped off at your program early, stays late, or does not want to go home

The parent:

• Shows little concern for the child
• Denies the existence of—or blames the child for—the child’s problems in your program or at home
• Asks caregivers to use harsh physical discipline if the child misbehaves
• Sees the child as entirely bad, worthless, or burdensome
• Demands a level of physical or cognitive performance the child cannot achieve
• Looks primarily to the child for care, attention, and satisfaction of emotional needs

The parent and child:

• Rarely touch or look at each other
• Do not respond to each other after a separation (such as at pickup time)
• State that they do not like each other
• Consider their relationship entirely negative

It’s not always easy to recognize child abuse and neglect. Remember that any one of these signs by itself does not necessarily mean a child has been abused or neglected. Often a pattern or combination of behaviors may lead to the suspicion that a child is experiencing abuse or neglect. Watch this video to learn about the physical and behavioral signs of abuse and neglect.

Asking Questions and Opening the Lines of Communication

All children get hurt occasionally: Bumps, bruises, and scrapes can be signs of healthy and active exploration. Sometimes, more serious accidents happen as well: A child pulls a cup of hot tea down on herself, or breaks a bone playing a sport, or is involved in a car accident. Sometimes, a medical condition causes symptoms that mimic abuse. For example, some skin conditions can leave marks that look like bruises or scars. To be most effective at protecting children from child abuse and neglect, you must be able to differentiate between accidents and abuse. Conversations are a powerful tool for doing so. Whenever you notice an injury or symptom in a child, ask a family member about the injury. This shows that all program staff members, regardless of role, take an interest in the child’s well-being. Remember, you are not investigating the injury. You are simply doing what comes naturally when someone is hurt: asking what happened and how the person is doing. Here are some tips for asking questions:

• Ask open-ended questions. You might say, “Ouch. That looks like it hurts. What happened?”
• Show concern and empathy: “I bet that was pretty scary for you all. How did it happen?”
• Make sure it’s an OK time to talk and be prepared to get help if the family needs it. For example, if you overheard a parent speaking harshly to a child as they entered the building, you might say to the parent, “I overheard you talking to Geri, you seemed pretty frustrated. Do you have a minute to talk?”
• Find out if there is anything else you should know about the injuries. “I’m glad you took her to the doctor. Is there anything we can do here at the program to make her comfortable during the day? Or is there anything she shouldn’t do?”

In most cases the family members will give you a clear and accurate account of what happened. For older toddlers, preschoolers or school-age children, you can also ask the child what happened. You might suspect child abuse or neglect if:

• The child’s answer and the adult’s answers do not match or if two different adults give conflicting stories about how the injury happened. For example, you are delivering lunches to the classrooms and as you are talking with the children, one child tells you the scratches on her face came from falling into a bush. When the child’s teacher talks to her dad later, he says she got them from a child at a birthday party.
• The story does not seem consistent with the child’s developmental level. For example, you might suspect abuse if a parent says a 4-month-old climbed out of a crib and got hurt.
• The story is not consistent with the injuries. For example, a child has burn marks all over his hands that look almost like gloves—his hands were clearly submerged in something hot. His mother says the child accidentally grabbed a pot off the stove. Accidental burn injuries usually show some kind of splatter patterns as the child pulls away.

Risk for Infants: Shaken Baby Syndrome

Shaken baby syndrome is a form of head trauma and brain injury. It can be caused by someone violently shaking, dropping, or throwing an infant. Most victims of shaken baby syndrome are under the age of 1, with the average age of victims being between 3 and 8 months. When babies are shaken, their neck muscles are not strong enough to control their heads. This causes the brain to move back and forth inside the skull. The result is bleeding and bruising of the brain. The effects are even worse when the shaking ends with a sudden impact, such as when a child is slammed into a crib or against a wall.

Look for the following symptoms of shaken baby syndrome. Remember, any one sign alone is not definitive evidence of abuse. Look for a combination of the following:

• Altered consciousness
• An inability to focus the eyes or track movement
• An inability to lift the head
• Decreased alertness
• Difficulty breathing
• Extreme irritability
• Lack of smiling or vocalizing
• Lethargy
• Pale or bluish skin
• Poor feeding
• Problems sucking or swallowing
• Rigidity
• Seizures
• Unequal pupil size
• Vomiting

Risk for School-Age Children: Internet Predators and Cyber-Bullying

Abuse can occur by family members or other adults that children are in regular contact with as well as online by adults they have never met. School-age children are growing up in a world of online social networks. They may have access to sites where they have “friends” they have never actually met. Unfortunately, the anonymous nature of the internet means that some of these contacts might be predatory adults. With personal devices, online communication is always open. Because of this, even though you may not directly care for children, you might be the closest adult to a child when they receive an inappropriate picture or a message that makes them feel uncomfortable.

All program staff must be on the lookout for signs that a child is engaged in dangerous or inappropriate relationships online. Make sure that you remind children of smart internet use guidelines when you see them on a device. To keep children safe, make sure you:

• Remind children never to meet a person they only know online.
• Discuss boundaries related to sharing images and content.
• Make sure that children feel safe talking to an adult if they receive inappropriate content from another child or an adult or are asked to share inappropriate content or images of themselves.
• Be aware of how you and your coworkers use your phones during program hours and make sure you are following the rules your program has put forth.
• To maintain firm boundaries, check your account privacy settings and avoid interacting with children in your program online.

All staff, regardless of role, must be on the lookout for children who are being victimized online. This victimization can come from other children, but it can also come from adults. There have been several high-profile cases of children being taunted, harassed, belittled, and insulted online. Sometimes, these stories come to light after the child commits suicide. Many victims are under the age of 12. Again, since internet-connected devices like phones allow communication to happen at any time, you may be the closest adult to a child when they receive an abusive message and need to talk. Observe for the signs of emotional abuse that you will read about later in the lesson.

Risk for School-Age Children: Crushes and Predatory Relationships

Later in the school-age period, children may begin to show an interest in sex and romantic relationships. It’s not unusual for children to have boyfriends and girlfriends. It’s also not unusual for school-age children to have crushes on teachers, coaches, or other staff members. As a support staff member, you must remain alert to these situations and know how to respond to them appropriately. You should always act within the boundaries of the program’s Guidance and Touch Policy and know how to respond if an older child does something that makes you uncomfortable, such as sitting on your lap, squeezing in next to you on the couch, grabbing your hand or asking personal questions. If you feel unsure of how to respond in these situations, talk to your Program Manager. While it can feel dismissive to turn away a child or establish a boundary, it is important to remember that you are protecting yourself from accusation and ensuring the child grows in a developmentally appropriate way. If a child asks you questions that demonstrate advanced sexual knowledge, this may qualify as reasonable suspicion of abuse and lead to you filing a report with Child Protective Services (CPS). FAP, CPS, and law enforcement. Avoid being alone with a child and never share images, videos, jokes, or content that are sexual or romantic in nature.

Remember that the young children and preteens that are a part of your program are children, and although they might have a crush, sexual activity or sexual touching is never consensual. If you suspect that a child is being sexually abused by another adult or teen, you must make a report. You will learn about reporting procedures in the next lesson.

See

The following are signs often associated with particular types of child abuse and neglect. Download and print the attachment in the Apply section for a complete list. It is important to note that these types of abuse are more typically found in combination than alone. A physically abused child, for example, is often emotionally abused as well, and a sexually abused child also may be neglected. Remember to remain aware of the two kinds of abuse: familial and institutional. The signs and behavioral indicators you see in children may be similar for each.

A Resonable Suspicion of Child Abuse or Neglect

It is not uncommon to question yourself when you suspect child abuse or neglect. In many ways, this is human nature: we want to see the best in families and coworkers. Unfortunately, doubting yourself about suspicions of child abuse or neglect can be dangerous. Something that can make this process easier is remembering that the signs listed above constitute a reasonable suspicion.

A suspicion is a belief that something is wrong. It is an inkling or a feeling, based on observation or experience, that a child is being mistreated. You do not need to prove that child abuse or neglect is occurring. You do not need to investigate. You do not even need to know who the suspected abuser is. If you think a child has been harmed, is in danger of being harmed, or have noticed any of the behavioral indicators or signs above, your suspicion of child abuse or neglect is reasonable and should be reported immediately.

Remember that every employee of the child development program is a mandated reporter of child abuse and neglect. Each staff member has a legal and ethical obligation to report suspicions of child abuse and neglect and can face penalties for failing to do so. The first step in meeting your obligation is recognizing when a child has been harmed or is in imminent risk of harm. Learning to recognize the signs of abuse and neglect is important, regardless of your role.

Common Conditions Mistaken for Abuse

There are several medical conditions that often bring about symptoms that could be mistaken for abuse. It is important to be aware of these conditions. But remember, you are not responsible for making medical diagnoses. If you have questions, ask the family or a community resource for support.

• Mongolian spots: These gray spots are present at birth and often look like bruises. They are usually found on the buttocks or lower back, but they can be found anywhere. They fade slowly over time.
• Blood or bleeding disorders: Some genetic conditions can cause severe bruising after common injuries, like falls on the playground.
• Bone deficiencies or diseases: Some bone diseases cause bones to break easily.

Cultural Practices Mistaken for Abuse

Some cultures have rituals or healing practices that might be mistaken for signs of abuse. All suspected concerns of abuse should be immediately reported. It is not your job to determine whether something you see is a cultural practice or an instance of abuse. You should make a report and let Child Protective Services (CPS) make that determination. This section is intended only to give you some basic information about customs that can be mistaken for child abuse. Two common examples are coining and cupping.

In coining, the chest, back, and shoulders are rubbed with a medicated ointment. Then a warmed copper coin is rubbed from the top of the shoulders down the back. Dark lines appear from the pressure and the heat. The marks, which look like long bruises, usually last for several days.

Cupping is a home-remedy used to relieve pain in the legs, back, chest, abdomen, or head. A small glass cup is held upside down and a candle is lighted inside it. The cup is quickly placed on the skin and a vacuum effect draws the skin up. A circular mark is left on the skin for several days. Often there is a series of cup marks along the affected area. Michael Phelps brought the practice to the forefront during the 2016 Olympics.

There are many other cultural practices that might be considered child abuse by state law. If you are unsure whether a mark is a sign of child abuse, it is always best to make a report. The appropriate authorities will make the determination.

Do

There are steps you can take to make sure you can recognize instances of child abuse and neglect. Take the following steps:

• Get to know all of the children in your program and their families, regardless of your role. You cannot recognize a problem if you don’t know what is typical for the child. Learn children’s patterns, temperaments, preferences, and abilities. Talk to families at every opportunity.
• Learn all you can about child development. Some changes in a child’s behavior can be startling—but completely typical. For example, it’s not unusual for toddlers to have bruises all over their legs or on their heads. Falling is a part of learning to walk and run! Young children may be scared of certain adults as part of typical stranger anxiety. Knowing these developmental stages can help you recognize when a child’s behavior goes beyond what is typically expected.
• Attend trainings on child abuse identification and reporting.
• Develop respectful communication skills. If you have a concern, ask about it. Ask open-ended questions that focus on the child’s well-being. “Is it OK if I ask you about Jordan’s bruises?” or “I’ve noticed that Tasha hasn’t seemed like herself lately. Is everything OK?” If something doesn’t seem right, gather as much information as you can.
• Learn about the cultures of the children in your program. Some cultures have rituals or healing practices that might be mistaken for signs of abuse. Ask your program administrator, or local resource and referral agency for information if you need help. When in doubt, make a report. Child Protective Services  will decide whether abuse has occurred.
• Learn reporting procedures for your state . You will learn more about this in the next lesson.

For Older Preschool and School-Age Children:

Be prepared to recognize the signs of child abuse and neglect in older preschool and school-age children. School-age children may become good at hiding physical signs of abuse and neglect. You might become suspicious because of something you hear. A child may also tell you that he or she is experiencing abuse or neglect. If a child tells you about abuse or neglect, educator Kenneth R. Lafontaine (1999) suggests doing the following:

• Listen. The child must voluntarily give information. Avoid asking leading questions like, “Did he abuse you?” or “Did she touch your private parts?” Many cases of child abuse and neglect have been unsubstantiated because the court decided the child’s testimony had been influenced by adults’ questions.
• Let the child know he or she is doing the right thing.
• Make it clear that abuse and neglect is not the child’s fault.
• Control your own emotions and remain calm.
• Do not promise not to tell. You cannot keep this promise. You must keep the child safe by making a report.
• Report the case immediately.

Keep information confidential and only share information with those who have a need to know.