CHARTING THE COURSE TOWARDS PERMANENCY FOR CHILDREN IN PENNSYLVANIA:

Transcription

CHARTING THE COURSE TOWARDS
PERMANENCY FOR CHILDREN IN
PENNSYLVANIA:
A Knowledge and Skills-Based Curriculum
MODULE TWO (2)
IDENTIFYING CHILD ABUSE AND NEGLECT
Standard Curriculum
Revised By:
Sharon S. England,
Evelyn M. Lopez
and
Gina M. McCone
Developed for:
The Pennsylvania Child Welfare
Training Program
University of Pittsburgh,
School of Social Work
August 2011
The Pennsylvania Child Welfare Training Program
University of Pittsburgh, School of Social Work
403 East Winding Hill Road
Mechanicsburg, PA 17055
Phone (717) 795-9048
Fax (717) 795-8013
Copyright © 2011, The University of Pittsburgh
This material is copyrighted by the University of Pittsburgh. It may be used freely for
training and other educational purposes by public child welfare agencies and other notfor-profit child welfare agencies that properly attribute all material use to the University
of Pittsburgh. No sale, use for training for fees or any other commercial use of this
material in whole or in part is permitted without the express written permission of the
Pennsylvania Child Welfare Training Program of the School of Social Work at the
University of Pittsburgh. Please contact the Training Program at (717) 795-9048 for
further information or permissions.
Acknowledgements
The Pennsylvania Child Welfare Training Program would like to thank the following
people for their assistance in the 2009-2010 revisions of Charting the Course Towards
Permanency For Children in Pennsylvania: Module 2, Identifying Child Abuse and
Neglect.
Susan Adamec - Susquehanna County Children and Youth/Trainer
Dave Arnold - Greene County Children and Youth
Khary Atif - Philadelphia Department of Human Services/Trainer
Linda Badger - Schuylkill County Children and Youth
Lori Baier - Lycoming County Children and Youth
Laura Borish - Pennsylvania Child Welfare Training Program
Debbie Bauer - Trainer
Tonya Burgess - Pennsylvania Child Welfare Training Program
Eleanor Bush - Statewide Adoption and Permanency Network/Family Design Resources
Robin Chapolini - Philadelphia Department of Human Services
Natalie Chesney - Snyder County Children and Youth
Pam Cousins - Elk County Children and Youth
Colleen Cox - Delaware County Children and Youth
Charles Crimone - Somerset County Children and Youth
Patricia Dervish - Trainer
William Dougherty - Pennsylvania Child Welfare Training Program
Marilou Doughty - Montgomery County Office of Children and Youth/Trainer
June Fisher - Trainer
Emma Fox - Northwestern Human Services
John Fox - Greene County Children and Youth
Michael Gill - Allegheny County Office of Children, Youth and Families/Trainer
Mary Grant - Delaware County Children and Youth
Lisa Hand - Northampton County Department of Human Services
Wendy Hoverter - Cumberland County Children and Youth/Trainer
Donna Kreiger - Springfield Counseling Services/Trainer
Daniel Krikston - Trainer
Tom Lacey - Montgomery County Office of Children and Youth
Evelyn Lopez - Philadelphia Department of Human Services/Trainer
Molly Mandes - Delaware County Children and Youth
Shawn McAuley - Cameron County Children and Youth
Gina McCone – Philadelphia Department of Human Services/Trainer
Julie McCrae - University of Pittsburgh
Angela McLarnon - Delaware County Children and Youth
Kathleen Moore - Trainer
Jan Miller - Pennsylvania Child Welfare Training Program
Kurt Miller - Lancaster County Children and Youth/Trainer
Leslie Molvihill - Montgomery County Office of Children and Youth
Joan Mosier - Trainer
Kristin Murphy - Delaware County Children and Youth
Edward Nowak - Trainer
Tina Phillips - Consultant
Mary Beth Rauktis - University of Pittsburgh
Shauna Reinhart - Pennsylvania Child Welfare Training Program
Elizabeth Rokin - Delaware County Children and Youth
Jeanne Schott - Pennsylvania Child Welfare Training Program
April Seeley - Bradford County Children and Youth
Charles Songer - Pennsylvania Children and Youth Administrators Association
Kathleen Swain - Pennsylvania Child Welfare Training Program
Charlene Templin - Allegheny County Office of Children, Youth and Families/Trainer
Caroline Tyrrel - York County Children and Youth Services
Doug Waegel - Chester County Children, Youth and Families/Trainer
Rose Weir - Snyder County Children and Youth/Trainer
Mike Whitney - Erie County Children and Youth
Claudia Witmer - Pennsylvania Child Welfare Training Program
Jane Zupanic - Washington County Children and Youth
The Training Program would also like to express its appreciation to all the dedicated
child welfare and other related professionals that assisted with the original version and
first revision of the curriculum that helped make this curriculum a reality.
Agenda for Two-Day Workshop on
Module #2, Identifying Child Abuse and Neglect
Day One
Estimated Time
35 Min.
1 Hour 20 Min.
2 Hour 30 Min.
1 Hour 35 Min.
2 Hours
40 Min.
1 Hour
1 Hour 40 Min.
20 Min.
20 Min.
Content
Section I:
Introduction to Identifying Child Abuse
and Neglect
Section II:
Casework Practice: Navigational Guide
and the Six Domains
Section III:
Defining and Identifying
Child Abuse and
Serious Physical Injury
Section IV:
Understanding Family Dynamics and
Behavior in Child Maltreatment
Day Two
Section V:
Child Sexual Abuse
Section VI:
Imminent Risk
Section VII:
Non-accidental Serious Mental Injury
Section VIII:
Serious Physical Neglect and
General Protective Services
Section IX:
Student Abuse
Section X:
Summary and Conclusion
Page
1
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Module 2: Identifying Child Abuse and Neglect
Section I: Introduction to Identifying Child Abuse and Neglect
Estimated Length of Time:
(35 minutes)
Performance Objectives: Participants will be able to:
 Recognize the competencies and learning objectives for Module 2;
 Recognize the skills and techniques personally used to take care of their
emotional health.
Methods of Presentation:
Lecture, Individual Activity, Large group discussion
Materials Needed:
 Flipchart stand
 Blank flipchart pad
 Colored markers
 Name tents
 Overhead Projector and Screen
 Post-it notes (Large)
 Handout #1 (Learning Objectives and Competencies)
 Handout #2 (Agenda)
 Handout #3 (Idea Catcher/Action Plan)
 Overhead #1 (Learning Objectives)
 Overhead #2 (Agenda)
 Overhead #3 (Activity)
 Appendix #1: (TOL Pre-Work)
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Section I: Introduction to Identifying Child Abuse and Neglect
Step 1: Introductions of the trainer, the facilities and participants
Lecture
(10 minutes)
Trainer Note: Prepare the training room in advance by placing name tents, markers,
and handout packets at each table. As participants arrive, greet each one.
Trainer Note: Promptly start the training session at 9:00 AM. By doing so, the trainer is
establishing promptness as the culture of the training program and promoting courtesy
to others. Later in this section, you will impart other important guidelines to be followed
throughout the 120 hours of training.
Trainer Note: If trainer provides handouts as a packet, it is recommended that trainer’s
remove Handout #18 from the packet and distribute it at that time of the activity in
Section III.
Welcome the participants to the training by introducing yourself and remind the
participants regarding any information about the training facility including location of
restrooms and, if known, restaurants. If available in the training room direct the
participants to the “facility guide,” which includes information about the facility and
nearby amenities.
Ask the participants to prepare name tents for this module. Ask the participants to print
their names on the tents and add additional information in the four corners of their name
tent. Tell them to write the county in which they work in the top left corner of the name
tent, their position in the agency in the top right corner, the length of time in their
position in the bottom left corner, and one a question that they have regarding child
maltreatment.
Trainer Note: To assist the participants, the trainer may prepare in advance on a flip
chart a model for how their name tents should be completed.
County
Length of time in position
Position
Question I have regarding child maltreatment
Trainer Prepared Flip Charts: Prepare a What’s In It For Me (WIIFM) and Parking Lot
flip charts in advance of the training. As the participants introduce themselves, the
trainer can record their questions they have regarding child maltreatment on the WIIFM
poster. In the alternative, the trainer may place Large Post- It notes on each table and
encourage participants to record their questions on the Large Post-its and place them
on the Parking Lot poster.
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Ask the participants to introduce themselves to the group and to the trainer by sharing
their name, agency, position and the question they have regarding child maltreatment.
Explain to the participants that at the end of the day you will review the WIIFM poster to
ensure that all of the concerns and questions have been addressed. Also, explain that
the “Parking Lot” is for those questions that will not be addressed in the training and the
trainer will direct them to a resource to answer parking lot questions by the end of the
module.
Step 2: Expectations and guidelines
Lecture
(5 minutes)
Remind the participants of the cohort list of training room expectations and guidelines
activity that was developed in Module 1. If the cohort list of training room expectations
and guidelines has not already been provided by one of the participants or is not
already posted in the training room, identify which participant volunteered to perform
this task.
Trainer Note: In Module 1 of the CTC curriculum, the participants prepared their
cohort’s list of training guidelines to supplement the CWTP standard list. If the two
sessions of Module 1 and Module 2 have been held back to back in the same room, this
cohort list may already be hanging in the room. If so, identify which participant agreed or
will agree to ensure that this list will be brought to Module 3. If the cohort list is not
hanging in the room, identify which participant has the list and then hang it up and
identify which participant will ensure that the cohort list be brought to Module 3. If this
training session is not part of a cohort group, guide participants through reviewing all of
the training room guidelines and adding any additional guidelines that they suggest.
Trainer Prepared Flipchart : The CWTP training room guidelines should be on a
prepared flip chart in advance, if not already provided in the room on a poster.
Schedule, timeliness and attendance
Remind the participants of the following Child Welfare Training Program policies and
guidelines:
 15 minute rule.
 Training Schedule – 9:00 to 4:00 with morning, lunch and afternoon
breaks.
 Document your presence -sign-in sheet and initial the 2nd day.
 Provide Constructive and Motivational Feedback .
 Respect.
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 Risk-taking.
 Practice makes permanent.
 Focus on Learning - No cell phones, texting, emails & only contact
office for emergencies.
Step 3: Agenda and Learning Objectives
Lecture
(3 minutes)
Distribute Handout #1 (Learning Objectives and Competencies) and refer to
Overhead #1 (Learning Objectives) and review the learning objectives for Module 2.
 Recognize the value and use of the Casework Practice: Navigational Guide’s
screening, investigation and assessment steps and the Six Domains in the
identification of child abuse and neglect;
 Identify the specific definitions of non-accidental serious physical injury, child
sexual abuse, imminent risk, non-accidental serious mental injury, serious
physical neglect, general protective services and student abuse as defined in
Pennsylvania’s Child Protective Services Law; and
 Recognize the physical indicators and family dynamics and behavior in child
maltreatment.
Distribute Handout #2 (Agenda) and refer to Overhead #2 (Agenda) and describe to
the participants how the learning objectives will be accomplished throughout the two
days of Module 2.
Step 4: Idea Catcher/Action Plan
(2 minutes)
Distribute Handout #3 (Idea Catcher/Action Plan) and encourage the participants to
record any ideas or concepts that they plan to use in the spaces provided and identify
how they intend to use it. Advise the participants that you will make reference to this
handout throughout the day.
Step 5: Identification of Child Maltreatment
(Activity)
2 minutes
Trainer’s Note: The participants were required to complete a transfer of learning (TOL)
pre-work assignment targeted on key content areas presented in Module 2 prior to
attending Module 2. They were directed to complete and print out a survey regarding
the identification of child maltreatment. (See Mod 2 pre-work TOL in the Trainer
Resource Manual) Do Not review the pre-work at this time. Throughout Module 2, the
trainer will be directed to emphasize material that corresponds to the survey questions
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asked in the pre-work TOL. Upon completing Module 2, participants will be directed to
respond to similar questions designed to survey the same concepts as those in the prework.
Ask the participants if they have completed the on-line TOL pre-work which included
questions regarding the identification of child abuse and neglect and whether they have
brought a print out of their responses. If the participants have not brought the print-out
of this pre-work, provide them Appendix #1 (TOL Pre-Work), which is a duplicate of
the survey questions in the pre-work.
Explain to the participants the information related to the pre-work TOL assignment will
be presented throughout the two days of Module 2. Ask them to keep this printout ready
and available throughout the day.
Step 6: Incidence of Child Maltreatment in Pennsylvania
Lecture
(3 minutes)
Explain to the participants that child maltreatment is a significant social problem
throughout this nation. Exposure to child maltreatment is known to have a long-term
impact on the child’s quality of life into adulthood. Studies supported and conducted by
the Center for Disease Control and Prevention have demonstrated that “adverse child
experiences” such as childhood maltreatment and trauma have a significant negative
impact on later adult functioning. The greater the number of exposures to trauma in
childhood resulted in the greater likelihood of the adult having significant health risk
behaviors, poor health status, and disease. (CDC, 2006)
The incidence of child maltreatment in Pennsylvania also is substantial. In 2009:
 Over 25,300 child abuse reports were received;
 Over 3,900 of those reports were substantiated; and
 51 percent of all reports involved child sexual abuse. (DPW, 2009)
Step 7: Values, Resistance and Vicarious Trauma
Lecture
(10 minutes)
Trainer Note: During the next two days of training, participants are going to be exposed
to the trauma of child abuse and neglect. For some of the participants this will be the
first time they are exposed to the details of child abuse and neglect. Throughout this
module it is important that the trainer maintain close observation of individual and group
dynamics and encourage the participants to share their concerns by providing a
supportive non-judgmental environment. Although the material on Shulman’s
Interactions Skills will not be presented until the next module, Module 3, the trainer may
prepare the participants for this material by making reference to “tuning in to self” and
tuning in to others”.
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Explain to the participants that in child welfare practice they will experience challenging
behavior and circumstances including encountering different values, cultures and
beliefs; resistance and hostility; and vicarious trauma, experiencing secondary trauma
and stress from the exposure to others. These experiences may cause the child welfare
professional discomfort, anxiety and stress. As it is important to forge a protective
partnership with families to effectively assure the safety, well-being and permanency of
children, the child welfare professional must intentionally “tune in to self” to identify
these reactions. Encourage the participants to recognize that these reactions are
normal. The question is not whether they will have these reactions. The question is
whether they will recognize that they are having these reactions and obtain support to
cope with them in a healthy recuperative manner and ensure that these reactions do not
interfere with effective case work practice. Remind the participants that today they will
be exposed to pictures and examples of serious physical abuse of children, which can
cause them to experience discomfort. Encourage the participants to view the training
room as a safe place to express their discomfort and receive support from the trainer as
well as other participants. Remind the participants that in Module 10, the last module,
they will learn much more about the skills and techniques to take care of themselves in
this very challenging position.
Display Overhead #3 (Activity) and ask the participants to identify the means by which
they prevent stress and the ways in which they cope with stress when it is occurring in
their lives?
Using Appendix #1 (TOL Pre-Work), refer the participants to Question 1 and inform
them that the correct answer is (b), that they are to “Kindly recommend Veronica to look
for another job as her reactions suggest that she is unable to handle the demands of the
child welfare practice.”
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Section II: Casework Practice: Navigational Guide and The Six
Domains
(1 Hour 20 Minutes)
Performance Objectives:
 When presented with a screening scenario the participants will identify questions
designed to gather relevant information according to the Six Domains.
Lecture, Large Group Discussion, Small group activity
Materials Needed:
 Flipchart stand
 Blank flipchart paper
 Colored markers
 Reference Manual for Charting the Course towards Permanency for Children
in Pennsylvania (15 table copies for use during the training, found in the training
room. NOTE: Participants were given this reference manual on CD in Module 1)
 Handout #4 (Phases of Casework Practice: Navigational Chart)
 Handout #5 (Steps in Navigational Guide)
 Handout #6 (CY-47 Report of Suspected Child Abuse)
 Handout #7 (Six Domains)
 Handout #8 (Overview of the Screening Process)
 Handout #9 (CY-104 Report of Suspected Child Abuse to Law Enforcement)

 Handout #11 (Screening Activity)
 Handout #12 (Photographing Children)
 Handout #13 (Transmittal on Miranda Warnings)
 Handout #14 (Case Status Determination)
 Handout #15 (CY 48: Child Protective Investigation Report)
 Overhead #4 (Children Youth Services Mandates)
 Overhead #5 (The Screening Process)
 Overhead #6 (Sequencing of the Interview)
 Overhead #7 (CPS Status Determination)
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Section II: Casework Practice: Navigational Guide and the Six
Assessment Domains
Step 1: Casework Practice: Navigational Guide
Lecture
(10 minutes)
Remind the participants that in Module 1, the day concluded with an introduction of
Pennsylvania law, regulations, and bulletins. Ask the participants if they have any
remaining questions from Module 1 about these laws and policies.
Explain to the participants that Pennsylvania laws and regulations mandate and define
the responsibilities of each county children and youth service agency and empowers
these agencies with the authority to implement these mandates. Display Overhead #4
(Children Youth Services Mandates) and explain that according to Pennsylvania law
and regulation every children youth service agency must:
•
•
•
•
•
•
•
•
•
Receive and investigate all reports of child abuse;
Implement a state-approved risk assessment process;
Develop a county plan for the provision of protective services;
Include among the services for the prevention, investigation and treatment of
child abuse:
1. Instruction and education services;
2. A multi-disciplinary team; and,
3. Investigative teams to investigate abuse or provider services to
children. At a minimum the team must include a health care provider,
county child welfare professional and law enforcement official.
Receive all reports of suspected child abuse and referrals for children in need of
general protective service assessments 24-hours a day, seven days a week;
Have procedures in place for child abuse investigations;
Have procedures in place for emergency placement and custody;
Protect the well-being of children who have been placed outside the care of their
parent, custodian or guardian; and
Administer a program of general protective services.
Explain to the participants that comprehending each of these mandated responsibilities
and formulating an ordered understanding of how to precede as child welfare
professionals is extremely difficult. It is simply too much information. To assist county
agencies and child welfare professionals in recognizing the steps and decision-making
involved in child welfare practice, a navigational guide has been created.
Distribute Handout #4 (Phases of Casework Practice: Navigational Chart) and refer
participants to the Casework Practice: Navigational Guide poster in the room and
emphasize to the participants that this navigational guide is integral to their casework
practice. Point out to the participants that it has been copied onto the back of their name
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tents and that their casework practice will greatly be enhanced if they always remain
aware of what step and decision-making point they are at in their intervention with
children and families.
Review with the participants the navigational guide and point out that this navigational
guide distinguishes between the “steps” in the casework process (denoted by a square
on the guide) from critical “decision-making” points (denoted by a diamond on the
guide). Each of these “steps” and “decision-making” points are governed by
Pennsylvania law, regulation and also clarified by bulletins as they learned in Module 1.
Explain to the participants that the navigational guide will be reviewed now. The steps
and decision-making regarding Referrals/Intake, Screening, Assessment, and
Investigation will be referenced more specifically throughout Module 2. In future
modules participants will learn more about Service Planning, Making Community
Referrals, Permanency Planning, Implementing, Revising, and Closing cases.
Distribute Handout #5 (Steps in the Navigational Guide) and explain to the
participants that this handout connects the law and regulation to each step and decision
making point in the Navigational Guide and will be referred to during the module.
Using Appendix #1 (TOL Pre-Work), refer the participants to Question #3 and advise
them b. Navigational Guide is the correct answer.
Step 2: Review of Casework Practice: Navigational Guide from Referral (step 1) to
Screening (step 2).
Lecture, Large Group Discussion,
(40 minutes)
 Step 1 in the Navigational Guide: Referral to CYS/Intake:
Explain to the participants that reports of child maltreatment may be made to ChildLine,
the Department of Public Welfare’s central clearinghouse for all investigated reports, or
to their own county child abuse hotline. Distribute Handout #6 (CY47: Report of
Suspected Child Abuse) and explain that ChildLine staff are required to provide a
written follow-up report, CY 47, to the investigating county children youth service
agency within 48 hours of their receipt of a referral.
Inform the participants that there are two sources of referrals: General Public and
Mandated reporters.
General Public: General public reporters can include but are not limited to: family
members, friends, and neighbors. These reporters may choose to remain Anonymous.
Mandated Reporters: Mandated reporters are required by law to report suspected child
abuse to the Department of Public Welfare’s ChildLine and when their report is made in
good faith they are immune from civil and criminal liability that might result from their
actions.
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Ask the participants to identify those individuals that they believe would be mandated
reporters and record their responses on flip chart paper. Answers may include but are
not limited to:
• Health Care Professionals
o Doctors
o Nurses
o Physical Therapists
o Home Health Aids
• Law Enforcement Officials
o Police officers
o Sheriffs
o Judges
o Court Officers
• Social Services Professionals
o Social Workers
o Therapists
o Child Care Workers
• Educational Professional
o Teachers
o Principals
o School Counselors
o Day Care Teachers
• Any individual who in their official capacity has contact with a child
Trainer Note: DPW has requested that the following ChildLine policy information be
presented to the participants:
• Reports made involving incidents occurring in other states are referred to the
appropriate state. A GPS report will be taken if the victim child now lives in
Pennsylvania. ChildLine will inform callers about the procedures for handling
out of state referrals. If the reporter agrees to contact the states where the
abuse occurred ChildLine will document this information on the GPS report that
is given to the county. If the reporter does not wish to contact the state where
the abuse occurred, ChildLine will make the report to the other state.
• Another state may forward information to our state known as “protective service
alerts” regarding a child that has been abused or is at risk from incidents that
occurred in their state and has reason to believe that the child has left their state
(the child’s current whereabouts are unknown). ChildLine will search their
database to attempt to determine if the child/family is known to ChildLine or a
particular county children and youth agency. We will forward the alert on to the
appropriate county agency or to all 67 county agencies if we cannot determine
what county the family may be currently located in.
 Step 2 in the Navigational Guide: Screening
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Explain to the participants that screening is the “Front Door” of the Child Protective
Services process. At this step, careful, detailed, and thorough work will lay the
foundation for making well-informed decisions throughout the life of a case. The quality
and consistency of the information gathered at this stage directly impacts subsequent
interventions and the child welfare professional’s entire child welfare practice.
The primary responsibility of the screener is to gather relevant information needed to
accurately determine the risk, safety and/or service needs of the child and to ensure
that a timely response is made to assure the safety and well-being of the child.
Inform the participant s that the screener also has an important role in public relations
for the children and youth agency. A referral source’s contact with the screener may be
the first and sometimes only contact he/she has with children youth services. Therefore,
it is very important for the screener to demonstrate a positive and respectful demeanor
to all callers.
Six Domains
Distribute Handout #7 (Six Domains) and explain that to assist child welfare
professionals in accomplishing the important task of identifying child maltreatment
nationwide, Action for Child Protection, has identified six assessment areas. These
assessment areas framed as questions on this handout are referred to as the Six
Domains and will be presented in more detail throughout Charting the Course Towards
Permanency for Children in Pennsylvania. The domains include:
•
•
•
•
•
What is the extent of the maltreatment?
What surrounding circumstances accompany the maltreatment?
What are the disciplinary approaches used by the parent?
What are the overall, typical pervasive parenting practices used by the parent?
How does the adult function in respect to daily life management and general
adaptation including mental health and substance use?
• How do the children function, including their condition?
(Action for Child Protection, 2010)
the participants that d. All of the above is the correct answer.
Distribute Handout #8 (Overview of the Screening Process) and using Overhead #5
(The Screening Process), briefly summarize the screening process with the
participants:
A.
The screening process is defined as the systematic gathering of information,
which is then used as the basis upon which two (2) major decisions are made:
1. Should the referral be accepted for evaluation by the agency?
2. What is the response time?
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B.
Screening requires comprehensive gathering of information from the referral
source. Effective, skillful work at the point of Screening is critical. The Screener
must be aware of not only their responsibilities to a child who may be in danger
of abuse or neglect, but also their responsibility to the community, especially to
the reporter. In addition, thorough information gathering and assessment are
essential since the screener in conjunction with his/her supervisor makes the
decision whether or not the referral is a valid report of abuse or neglect, and if it
is, determine its urgency. When reports of child maltreatment are received, it is
crucial that the screener use engagement and Interactional Skills (that will be
discussed in Module 3) to gather sufficient information from the reporter.
C.
If the referral is not accepted for investigation or assessment, the information
gathered helps the screener to determine if the reporter should be referred to
another community agency for assistance. (Information & Referral)
D.
Assignment of a response time referred to as “Safety Tag or Tag.”
1. CYS staff must make an immediate decision about how and when to
respond to the report in the consideration of the presence of absence
of safety threats and risk factors before passing on the report for
processing or assignment.
2. Safety and Risk assessments and the assignment of Safety Tag will be
discussed in greater detail in Module 4.
Trainer Note: Inform the participants that in some counties, the screener may
determine the safety tag while the supervisor determines the response time.
Trainer’s Note: The Safety Assessment and Management Process including the
determining the safety tag will be discussed thoroughly and completely in Module 4.
Just simply introduce these concepts here and avoid any detail explanation.
Distribute Handout #9 (CY 104: Report of Suspected Child Abuse to Law
Enforcement Official) and inform the participants that in the event the report of
suspected child abuse involves allegations of homicide, sexual abuse or exploitation, or
serious bodily injury perpetrated by persons related or not to the victim they must
complete this form and send to law enforcement officials, keeping a copy for
themselves.
Trainer’s Note: Participants were asked in the pre-TOL activity to bring in a copy of
their agency’s screening form to this module.
Ask the participants if they brought in a copy of their agencies’ screening form and ask a
volunteer or two to share the contents of their form. Explain to the participants that
Pennsylvania does not mandate the use of a standardized statewide screening form.
However, certain areas of information must be present in any version. Agencies may
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adapt a screening format to fit their own intake documentation process. These
mandated areas include:
•
•
•
child factors;
caretaker factors; and
family environment.
Screening forms must also include a:
•
•
•
•
screener “Safety Tag”;
the basis for the Safety Tag;
the disposition—accepted for assessment/investigation or unaccepted; and
the response time (immediate, 24 hours, and other).
Ask the participants to identify what additional screening information they might obtain
in addition to general demographic questions to obtain more in-depth information to
make an initial determination of present danger and record their answers of a flip chart.
Suggested responses include but are not limited to:
Action, if any, taken by the reporter;
Reporter’s demographic information;
Reporter’s relationship with the child and parents and/or alleged abuser;
Reporter’s knowledge regarding the:
Parent’s and the child’s functioning;
Family’s circumstances or possible contributors to the maltreatment;
Type of maltreatment and circumstances surrounding it;
Parents typical style of discipline; and
Strengths of the family.
Other possible witnesses or information sources;
Reporter’s reasons or motives for reporting at this time;
Explain that some questions such as the one regarding the reporter’s relationship with
the child and family and those that seek the reporter’s opinion regarding the family will
assist the screener to evaluate the perspective and objectivity of the reporter. It also is
very important for the screener to distinguish between actual events and the reporter’s
interpretation of events.
Distribute Handout #10 (Screening Activity) and ask the participants to imagine that
they are in a screening unit assigned the task to gather relevant information. In a large
group assist them in identifying questions for scenario 1. Encourage the participants to
include questions that would respond to the six domains identified in Handout #7 (Six
Domains) and challenge the reporter to identify family strengths. After they have
completed this task assign each table group one of the four remaining scenarios. Ask
the table groups to identify questions to gather similar relevant information and record
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those questions on flip chart. After 10 minutes, ask each table group to present their
questions to the larger group. (Suggested questions for each scenario are provided
below.)
1. A family member reports that Kelsey (10) suffers from asthma and has not been
receiving her medication.
1. “What convinced you to take action and call us now?”
2. “Has her condition worsened as a result of her not receiving her medication?
3. “What is the parent or caretaker’s response to the child’s medical needs?”
4. “How pervasive is the asthma? Is it seasonal or does she require daily
medication?”
5. “Has the child ever been hospitalized due to her asthma?”
6. “Has the parent been responsive to your concerns?”
7. “Is the child receiving routine medical care?”
8. “Are there any other children in the family? Any concerns with their care?”
2. A neighbor reports that there are 6 children in the home, and that they are frequently
left alone. Today, Gabe, 4 yrs old, burned himself with a curling iron and has 2nd degree
burns on his left arm.
1. “Were the children home alone today?
2. “Did Gabe receive medical treatment?
3. “How was the child burned?”
4. “Did you see the child?”
5. “How often are the children left home alone?
6. “How old are the children?”
7. “Can you tell me anything about the parents, caregivers or any other
household members?”
8. “What do you imagine us doing to make the child (ren) safer?”
3. A reporter claims that Tom, age 12, sexually assaulted his 7 year old sister, Lisa,
while mom was out shopping for groceries.
1. “What do you mean by sexually assaulted?”
2. “Was Tom babysitting for his sister at the time?”
3. “How did you receive this information?
4. “What did Lisa say happened? Are those the exact words the she used?”
5. “How long mom was out of the home?”
6. “Has an incident such as this has happened in the past?” If so, do you know if
mom was aware?”
7. “Where are Tom and his sister now?”
8. “What can you tell me about how Tom and Lisa function?
4. A reporter claims that John, 3 years old, is being abused by his mother. He came to
the door today with 2 black eyes.
1. How is John being abused by his mother?
2. How does John usually get punished?
3. Did John tell you how he received the black eyes?
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4.
5.
6.
7.
Did you ask mom how John got the black eyes?
Was John medically treated?
Has John ever had any other types of injuries or bruises?
How does mother react to John when he misbehaves?
5. A reporter reports that Daniel 13 yrs. old is emotionally abused by his parents, as a
result he is withdrawn and possibly suicidal.
1. Can you give some example of how Daniel is emotionally abused at home by
his parents?
2. How does Daniel feel and react towards his parents?
3. Does Daniel have any friends?
4. Is he involved in any afterschool activities (sports, clubs etc)?
5. Has Daniel ever tried to hurt himself?
6. Is Daniel receiving any type of counseling to deal with his parent’s behavior?
7. How is Daniel doing in school academically, socially, and behaviorally?
8. Are there any other children in home?
Ask the participants to identify the importance of the screening for strength based
information from the reporter. Possible responses include but are not limited to:
1. Questions prompting the reporter to identify strengths may cause him/her to think
more critically about the situation.
2. Exceptions, strengths, and goal-oriented questions cause the reporter to think
about the family’s situation and stress the idea that child safety and protection is
a community issue, which calls for collective responsibility.
Inform the participants that it can be challenging to obtain strength based information
from reporters possible due to:
1. It is easier/simpler for people to focus on problems.
2. These types of questions may be unexpected.
3. It will take more time for the screener to explain the rationale for strength based
questions.
4. Some reporters will be reluctant to expand upon their report believing that they
have fulfilled their duty by notifying the authorities of the problem.
Remind participants that at the screening step, a determination regarding whether the
report will be referred for a Child Protective Service (CPS) investigation or a General
Protective Services (GPS) Assessment also will be made. Clarify with the participants
that often the terms assessment and investigation are interchanged. However, they
should be clear that CPS referrals are investigated and GPS referrals are assessed. On
the second day of this module, participants will learn more about the definition of GPS.
In future modules they also will learn about other types of assessments, such as safety,
risk, and family assessments. Those assessments also should not be confused with a
GPS assessment.
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 Step 3 in the Navigational Guide: Make Community Referrals:
If the screening process determines that the referral information does not require an
investigation or an assessment and the referral does not involve a child’s safety, wellbeing, or permanence, the screener may then refer the caller to another social service
agency or organization in the community for assistance. Remind the participants that
making referrals is important as it can support prevention of future child maltreatment.
Step 3: Review of the Casework Practice: Navigational Guide: Assessment and
Investigation and Remaining Steps
Lecture,
(30 minutes)
 Step 4 in the Navigational Guide: Assessment Investigation:
Remind the participants that it is important for the child welfare professional to
distinguish between assessment and investigation. If a referral is deemed to be alleged
situation involving general protective service including child neglect the matter will be
assessed. The assessment process will be discussed in the second day of Module 2. If
the referral is deemed to involve an allegation of child abuse, the matter will be
investigated. Refer the participants to page 3 of Handout # 5 (Steps in the
Navigational Guide) and review with them very briefly part 4 sections, ii, iii, iv, again
reminding them that these areas will be discussed in greater depth in the Module 4 and
5.
Using Appendix #1 (TOL Pre-Work), refer the participants to Question #2 and the
participants that d., the appropriate county agency for a GPS assessment is the correct
answer.
Trainer Note: DPW has requested that CPSL Section 6334 Disposition of Complaints
Received (d) Incidents Occurring Outside of this Commonwealth be emphasized to the
participants.
(1) A report of suspected child abuse occurring in another state where the child
victim is identified as a resident of this Commonwealth and the other state child
protective services agency cannot investigate the report because of statutory or policy
limitation shall be assigned as a general protective services report to the county of the
child’s residence or as determined by the Department.
(2) In addition to complying with the other requirements of this chapter and
applicable regulations, a copy of the report shall be provided to the other state’s child
protective services agency and, when applicable under PA law, to law enforcement
officials where the incident occurred.
(3) Reports and information under this subsection shall be provided within seven
calendar days of completion of the general protective services assessment under
section 6375 (relating to county agency requirements for general protective services).
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Sequencing Interviews:
Point out that section v identifies those individuals who must be interviewed as part of a
CPS investigation. Display Overhead #6 (Sequencing of the interviews) and explain
to participants that it is considered best practice to interview the victim child first,
followed by the siblings or other involved children, the non offending parent and the
alleged perpetrator.
the participants that c. Alex, Alice, Susan and James is the correct answer. However,
remind the participants that this is guidance on best practice; circumstances could
support another ordering participants that d. All of the above is the correct answer.
Photographing Children:
Photographing Children who are the Subject of a CPS Investigation and All Children
Accepted for Services
Inform the participants that child welfare professionals must take a photograph of all
children who are the subject of a child abuse investigation and of those children who are
accepted for services, regardless of the reason for acceptance. The identification photo
is a separate photo for the case record, taken in addition to any photographs of injuries
as required under CPSL. All photos and annually updated photographs must be
maintained in the case file for 5 years after the closure of the family’s case.
Distribute Handout #11 (Photographing Children) and inform the participants that per
Regulation 3490.55: A visual examination of the subject child must be made by the
child welfare professional to determine the nature and extent of the injuries.
If it is necessary for the child to remove clothing to observe the injury the following
guidelines will be observed:
 The parent/caregiver, or another adult person of the same sex as the child,
should be present.
 The child’s permission should be sought.
 If the child is resistant to the examination, it should be done by an appropriate
medical provider.
 If the child is over 10 years, the exam must be conducted by a CPS worker of the
same sex as the child if clothing is removed.
 Most of the body can be exposed for examination without exposing more than
would be uncovered if the child wore a two-piece bathing suit.
If the child has sustained a visible injury, the child welfare professional must take or
obtain a color photograph of the injury.
 The policies for examining a child also apply to photographing a child.
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


Individual counties may have policy regarding the photographing of a child’s
genitals. However, in all situations where this may need to occur, supervisory
consultation and professional discretion is essential.
If, in the event of injuries to a child’s genitals, pictures, if any, shall be taken by a
medical professional.
If the parent or guardian is not present, his/her permission is not required for
photographing the child.
Clarify for the participants that photos will include one snapshot in which the child is
clearly identifiable with the injured part of the body visible in order to establish the
identity of the child and the location and extent of the injury. More than one photograph
is to be taken if it’s necessary to obtain a clear close-up of the injury. If no injuries are
present, a picture should still be taken and documented in the record that no injuries
were observed of the child.
CPS workers must affix a label to the back of each photograph containing the following
information:
 Name of child;
 Case Number and suffix;
 Age of child at time of photograph;
 Photo taken by;
 Date of photo;
 Time that photo was taken;
 Location of photo;
 Names of any witnesses present; and
 Signature of photographer (and printed name).
Ask the participants to describe how pictures are taken in their agencies, such as with
cameras, cell phones or other means?
Trainer’s Note: Explain to participants that all bruises should be documented clearly by
a description of their location, size, color, and shape. Pictures should be taken within
the first few days of the incident. A reference scale, such as a ruler, should be included
in the photograph to indicate the size of the mark. A second set of photos may need to
be taken as bruises may not appear on the skin until a few days after the injury.
Distribute Handout #12 (Transmittal on Miranda Warnings) and inform the
participants that child welfare professionals must exercise caution when interviewing
alleged perpetrators of child abuse. According to this memorandum, when an alleged
perpetrator is in the custody of law enforcement officials, the child welfare professional
is required to read the Miranda rights to the individuals prior to asking any questions.
A caseworker does not have to provide the Miranda Warning to an alleged perpetrator
of child abuse if the perpetrator is not in the custody of law enforcement officials. If,
however, the alleged perpetrator is in the custody of law enforcement official for alleged
criminal offenses related to the alleged child abuse, the caseworker is required to
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advise the alleged perpetrator of his Miranda rights as described in this transmittal.
Remind the participants best practice is discuss this action with their supervisor prior to
conducting an interview with an alleged perpetrator in the custody of law enforcement
officials.
Distribute Handout # 13 (Case Status Determinations) and display Overhead #7
(CPS Status Determinations) and review with the participants the finding that must be
made in a child abuse investigation.
“Indicated report” - a report pursuant to the CPSL is an investigation by CYS determined
that substantial evidence of the alleged abuse/neglect exists based upon:
• Medical evidence.
• CPS investigation.
• Perpetrator admission.
“Founded report” - a report made pursuant to CPSL, if there has been a judicial finding
that the child who is the subject of the report has been abused or neglected
“Unfounded report” – a report made pursuant to CPSL that is not a “founded report” or
the CYS worker has determined that there is not substantial evidence to “indicate” a
report of suspected abuse/neglect.
Explain to participants the importance of documenting and reporting on information
gathered in the process of identifying child maltreatment. Distribute Handout # 14
(CY48 Child Protective Services Investigation Report) and explain that this form
must be completed and submitted to ChildLine at the conclusion of an investigation of
child abuse. This form must be completed in its entirety and submitted within 30 days
calendar days of when the report was received at ChildLine.
However, exceptions can be made if there is pending court action. If that is the case,
the “pending juvenile court action” or “pending criminal action section must be
completed”, however, be clearly identified on the CY48 and an updated CY48 will be
required. Also inform the participants that a CY49 can be used to review, and/or revise
the CY48.
A CY49 form is a supplemental child abuse report form. This form is to be submitted to
ChildLine on founded and indicated reports when additional case information is
obtained, including dates of birth, identity of the subjects, additional information about
the nature of the abuse, or the case is presented before a court and there is a change in
the status of the report.
Trainer note: Explain that, although the expectation is that the CY48 will be completed
within 30 calendar days of the commencement of a CPS investigation; ChildLine will
accept the CY48’s submitted prior to the 60th day. Documentation of the reason for
going beyond the 30-day requirement must be provided. However, If the CY48 is not
submitted within 60 calendar days, the report will be automatically “unfounded”.
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Explain to the participants that in future sections they will learn more about the type of
information that must be documented to support the child welfare professional’s
findings.
Briefly review the remaining steps in the Navigational Guide and remind the participants
that more detail regarding these steps will be presented more thoroughly in future
modules.
 Step 5 in the Navigational Guide: Service Planning:
This step occurs when the case has been opened for services and requires the
development of a Family Service Plan, which is a separate and an interconnected part
of safety management for the child.
 Step 6 in the Navigational Guide: Permanency Planning:
This step refers to those cases in which a child has been placed out of the home to
assure his/her safety and a Family Service Plan and a Child Permanency Plan is
developed to guide the decision-making about reunification and child permanency.
 Step 7 in the Navigational Guide: Implement Plans:
This step refers to the process of implementing the services outlined in Service
Planning, including the Family Service Plan and the Child Permanency Plan.
 Step 8 in the Navigational Guide: Review, Revise & Implement Plans:
This step refers to the periodic and on-going process of evaluating and monitoring the
child’s safety and determining whether services being provided are adequate to
increase protective capacities or needs to be changed or updated. Typically, this is
done at least every six months, but should be done on a more frequent basis as
required by regulations and best practice.
 Step 9 in the Navigational Guide: Case Closure:
This step refers to the ending of services due a variety of reasons. The most preferred
reason is the family’s satisfactory completion of the goals outlined in the Family Service
Plan and there are no longer any threats to the child’s safety. However, other reasons
may prompt this closure, such as moving out of the area, court orders, refusal of
services, etc.
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Section III: Defining and Identifying Child Abuse and Serious Physical
Injury
(2 hours 30 minutes)
 When presented with case scenarios the participants will correctly identify those
scenarios that may involve serious physical injury using a two step inquiry;
 When presented with pictures depicting injuries, the participants will identify
relevant questions to gather information.
Lecture, Large Group Discussion, Large Group Activity
Materials Needed:
 Flipchart stand
 Colored markers
 Masking tape
 Lap top
 Television
 Handout #15 (Child Abuse Definitions)
 Handout #16 (Non-accidental Court Case Examples)
 Handout #17 (Court Rulings on Non-accidental Court Case Examples)
 Handout #18 (Questioning)
 Handout #19 (Reaction to Pictures of Physical Injuries to Children)
 Overhead #8 (Child Abuse is…)
 Overhead #9 (Categories of Child Abuse)
 Overhead #10 (Non-accidental Serious Physical Injury)
 Overhead #11 (Determination of Non-accidental Serious Physical Injury)
 Overhead #12 (Non-accidental Rationale)
 Overhead #13 (Conditions of Abuse)
 Power Point Presentation
 Appendix #2: Laminated Photographs 1 – 10
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Section III: Defining and Identifying Child Abuse and Serious Physical
Injury
Step 1: Defining Child Abuse
Lecture, large group discussion
(15minutes)
Explain to the participants that to become an effective child welfare professional they
must know and understand how Pennsylvania law defines child maltreatment. Ask the
participants to identify which Pennsylvania law provides a definition for child abuse.
Praise any participant that can correctly identify the Child Protective Service Law
(CPSL) Remind the participants that they reviewed this law in Module 1 and explain that
that for the remainder of Module 2 the emphasis will be on defining and identifying
different types of child abuse and the type of parental conduct including child neglect
that can result in the provision of general protective services.
Remind the participants that they can find and access Child Protective Service Law and
the Juvenile Act in the Charting the Course Towards Permanency For Pennsylvania’s
Children Resource Manual that is located in the training room. Remind the participants
that they were provided a CD which contains the entire contents of this manual in
Module 1.
Distribute Handout #15 (Child Abuse Definitions) and display Overhead #8 (Child
Abuse Is…) and provide an overview of provisions in the law.
Explain to participants that in Pennsylvania child abuse must involve a child, a
perpetrator and an act of abuse as defined below:
•
•
A child is a person who is under the age of 18.
A perpetrator is a person who has committed child abuse and is:
o A parent of a child;
o A paramour of a child’s parent;
o An individual 14 years of age or older residing in the same house as the
child; and
o A person responsible for the child’s welfare…NOTE: this person may be
under the age of 14.
Explain to the participants that Child Protective Service Law also distinguishes between
perpetrator by commission and perpetrator by omission.
•
Perpetrator by Commission: A person who actively participated or sanctioned the
abuse or neglect of the child.
•
Perpetrator by Omission: A person who by their failure to act allowed the child to
be abuse/neglected or willingly placed him/her at risk.
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Ask the participants to identify who they believe would be “a person responsible for the
child’s welfare” and record their suggestions on a flip chart.
Answers may include:
Parents; babysitters; day care workers; mental health professionals; siblings; or a
parent’s paramour.
Inform the participants that a parent’s paramour does not have to live in the home with
parent and is defined as a person with an on-going intimate relationship with the child’s
parent at the time of the alleged abuse/neglect.
Clarify that a sibling can be considered a perpetrator if he/she is at least 14 years old or
unless he/she is a caretaker, i.e., babysitter.
Display Overhead #9 (Categories of Child Abuse) and inform the participants that the
CPSL and Pennsylvania regulations, Pa. Code 3490, identify five categories or types of
child abuse: They are:
•
•
•
•
Any recent acts or failure to act by a perpetrator which causes nonaccidental
serious physical injury to a child under 18 years of age;
An act or failure to act by a perpetrator which causes nonaccidental serious
mental injury to or sexual abuse or sexual exploitation of a child under 18
years of age;
Any recent act, failure to act or series of such acts or failures to act by a
perpetrator which creates an imminent risk of serious physical injury to or
sexual abuse or sexual exploitation of a child under 18 years of age; and
Serious physical neglect by a perpetrator constituting prolonged or repeated
lack of supervision or the failure to provide essentials of life, including adequate
medical care, which endangers a child’s life or development or impairs the child’s
functioning.
Emphasize to the participants that no child shall be deemed to have been abused
based on injuries that result solely from environmental factors that are beyond the
control of the parent or the person responsible for the child’s welfare, such as
inadequate housing, furnishings, income, clothing and medical care.
Also, if a child has not been provided needed medical care or surgical care due to
seriously held religious beliefs and those beliefs are consistent with those of a bona fide
religion, the child will not be deemed to be abused. However, the county must closely
monitor the child and seek medical intervention when the lack of medical care or
surgical care threatens the child life or long term health.
Remind the participants that all times the child welfare professional must consider and
respect cultural and religious variances that may impact a parent’s interpretation and
behavior.
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Explain to the participants that the remainder of today will focus on defining and
identifying non-accidental serious physical injury and understanding the family dynamics
in child maltreatment. The other types of child abuse, general protective services
including child neglect and student abuse will be presented on the second day of
Module 2.
Step 2: Non-accidental Serious Physical Injury
(Lecture, Large Group Activity)
(60 minutes)
Display Overhead #10 (Non-accidental Serious Physical Injury) Explain to the
participants that under the CPSL and Pa. 55 § 3490.4 (C) non-accidental serious
physical injury is defined as:
•
Any recent act or failure to act by a perpetrator, which causes non-accidental
serious physical injury to a child less than 18 years of age. Serious physical
injury is an injury that:
o Causes a child severe pain; or
o Significantly impairs a child's functioning, either temporarily or
permanently.
Emphasize to the participants that the law does not require the child to experience both
a serious physical injury that significantly impairs a child's functioning, either temporarily
or permanently and severe pain. Serious physical injury can occur with one or the
other.
•
Recent Act or omissions is defined in the CPSL definition section as those
“acts or omissions committed within two years of the date of the report to the
Department of Public Welfare or county agency.”
Trainer Note: ChildLine Policy clarification states that the CPSL does not specify that a
report of suspected child abuse must be made prior to the victim’s eighteenth birthday.
As long as the alleged incident occurred when the victim was 17 years of age or
younger, the Department will accept reports which are reported when the victim is under
the age of 20. ChildLine will also refer persons age 20 or over alleging child abuse to
law enforcement officials.
Inform the participants that the determination of when non-accidental serious physical
injuries occur has been subject to numerous court decisions, including by the Supreme
Court of Pennsylvania. Display Overhead #10 (Non-accidental Serious Physical
Injury) and explain that it has been determined that the first inquiry is the determination
as to whether a serious physical injury has occurred. If it is determined that a serious
physical injury has occurred, then the second inquiry is to determine whether the
serious physical injury was non-accidental. Therefore, it is possible, under Pennsylvania
law, for a child to experience a serious physical injury, but found not to be abused, if the
injury is determined to be accidental.
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 First Inquiry: Serious Physical Injury
 Significantly Impairs a child’s physical functioning, either temporarily or
permanently.
Explain to the participants that when determining whether an injury “significantly impairs
a child’s physical functioning, either temporarily or permanently” they must rely on
objective information. Such injuries can include but are not limited to:








severe bruising,
burns,
broken bones,
lacerations,
internal bleeding,
shaken baby syndrome,
choking; or
any other injury that can significantly impairs a child’s physical functioning,
either temporarily or permanently.
The identification of a permanent impairment may be easier to make then a temporary
impairment and typically will be readily documented by a medical professional. Ask the
participants to identify other injuries that may significantly impair a child’s physical
functioning, temporarily.
Answers may include: a bruising on a child’s buttocks that prevents the child from sitting
or laying down for a length of time interfering with the child’s ability to rest, perform
tasks, or sleep.
 Severe pain:
Ask the participants to define severe pain. After several answers are provided, inform
the participants that there may be as many definitions for severe pain as there are
people in the room. Explain to the participants that the determination as to whether
severe pain has occurred can be difficult as it requires a subjective interpretation as to
what constitutes severe pain. “What is painful to one child may not bother another.”
L.A.J. V. Department of Public Welfare, 726 A.2d 1133 (Pa. Cmwlth. 1999). Therefore,
the determination as to whether or not the child experienced severe pain may present
challenges to the child welfare professional charged with making this determination.
Inform the participants that based on a review of court decisions in cases involving the
question of whether a child experienced severe pain it appears that best practices in the
child welfare professional’s determination of severe pain requires:
•
•
An objective unbiased approach;
Avoiding construing words such as “hurt, sore, painful to mean severe pain;
Page 25 of 86
•
Meticulously documenting facts leading to the determination that severe pain
occurred.
Activity: Provide the participants an opportunity to make a determination as to whether
severe pain was experienced by a child; provide the following scenarios based on
actual court cases. At the conclusion of each scenario ask those participants who
believe the child experienced severe pain to walk to the front of the room and the
participants who believe the child did not experience severe pain to walk to the back of
the room. Once the participants have made their assessment, ask each group to identify
those factors that influenced their decisions. Before moving on to the next scenario
provide the participants the court’s ruling.
Trainer’s Note: If participants are prompted to ask questions regarding court hearings
and substantial evidence place those questions on the parking lot and inform them that
these terms and processes will be discussed more thoroughly in Module 7.
•
Scenario 1: The child winced when a bruised area was touched and screamed
when an attempt was made to apply cold compresses or ice to a bruised area.
•
•
Court’s ruling: “…Sufficient to establish an injury resulting in severe pain. S.
T.v. Department of Public Welfare, Lackawanna County Office, Children
Youth & Family Services, 681A.2d 853 (Pa. Cmwlth. 1996), appeal denied,
690 A.2d 1165 (Pa. 1997).
Scenario 2: The mother, admitted that she hit her 10-year- old son four or five
times with a pool stick (not regulation size, 1 inch by 4 feet) breaking the stick ,
and causing bruises and welts on child’s right forearm and on the right side of
back . Photograph showed “faint bruising” and “some discoloration.” The child
reported those areas were still “sore” the day after the incident.
•
Court’s ruling: Department of Public Welfare’s (DPW) did not carry its burden
of demonstrating that the child experienced severe pain. City of Philadelphia
Office of Children, Youth and Family Services v. Department of Public
Welfare, No. 2568 C.D. 1999)
Trainer’s Note: Emphasize to the participants that in several court rulings, the court
refers to the lack or insufficiency of the evidence which underscores the importance of
clearly documenting the two part inquiry.
•
Scenario 3: Photographic evidence of child showed: “From several inches above
his belly button and extending to his genitals, red bruising covered the subject
child’s skin….On his backside, red bruising covered the subject’s child’s body
from the middle of his torso to his buttocks…Red bruising also covered almost
the entire right side of the subject’s child right thigh from hip to knee…Several
spots on the child’s groin and above his right knee contained dried blood showing
where the skin was broken.”
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•
•
Court’s ruling: “…A finding that a child has suffered severe pain does not
need to be supported by witness testimony or medical
evidence…photographs alone of a child’s injuries may support a finding that
the injuries caused the child severe pain. …one can reasonably infer that the
injuries caused severe pain. S.T. v. Department of Public Welfare,
Philadelphia Department of Human Services, No. 91 C.D. 2008.
Scenario 4: Father used open hand to spank 10 year old son for lying about a
homework assignment. Photograph taken a week after the incident depicted
bruising widespread across both hemispheres of child’s buttocks. Child testified
that on a scale of 0-10, with 0 representing no pain and 10 representing the most
pain he ever experienced, he experience a pain level of about 8 or 9.
•
Court’s ruling: Child’s rating of pain experienced supported finding of severe
pain and “photographic evidence taken one week after the incident, further
provides ample evidence to support the reasonable inference that P.R. was in
severe pain following the spanking.” The court also found the child
experienced “functional impairment.” F.R. v. DPW (Pa. Cmwlth. 2010)
At the conclusion of all of the scenarios, tell the participants to return to their seats and
ask them how can they obtain objective information regarding a child’s experience of
severe pain. Answers can include but are not limited to:
• Consult a medical professional;
• Observe the child’s behavior;
• Obtain the report of a witness who may have observed the child’s response to
the injury; and
• Ask the child, depending upon his/her cognitive abilities, a scaling question (1
to 10, with 10 being the worse pain ever) regarding how much pain he/she
experienced;
Trainer Note: Emphasize that under CPSL 6368 (a) and Pa. Code 3490.55(h): If the
investigation indicates serious physical injury, a medical examination shall be performed
on the subject child by a certified medical practitioner. However, it is not required that
the medical practitioner confirm that the child experienced severe pain or impairment.
Ask the participants to identify other types of questions they would ask to assess the
level of the child’s pain.
Remind the participants that when documenting severe pain, relying upon personal
values and bias can undermine the child welfare professional’s credibility and
effectiveness. Interpreting words such as hurt or sore to mean severe pain or without
clearly documenting the statements, observations, or medical evidence to support that
conclusion can result in a determination that severe pain did not occur when it actually
did occur again leaving a child unsafe.
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Trainer Note: Explain to the participants that if the first inquiry determines that there is
no serious physical injury then there is no need to pursue the second inquiry.
 Second Inquiry: Non-accidental
Refer the participants to the second page of Overhead #11 (Determination of Nonaccidental Serious Physical Injury) and explain that Pennsylvania defines nonaccidental injury as:
“An injury that is the result of an intentional act that is committed with disregard or a
substantial and unjustifiable risk.”
Display Overhead #12 (Non-accidental Rationale) and explain to the participants that
the background for this standard is as follows:
 Under Pennsylvania law, parents are not prohibited from using corporal
(physical) discipline with their children. CPSL §6303 (c).
 Therefore, it is permissible for parents to use corporal punishment to discipline
their children.
 Realistically, corporal punishment is undertaken with the intent to inflict pain.
 Therefore, a parent’s intent to inflict pain on their child or an intentional striking of
a child by a parent does not automatically cause that act to be considered nonaccidental or not allowable under Pennsylvania law.
 However, these intentional acts can cross the line into non-accidental or
unallowable acts.
 The challenge for the child welfare professional is to determine whether the
parent’s intentional act has crossed the line and was committed with a “disregard
or a substantial and unjustifiable risk” and to document this determination with
substantial evidence.
Explain to the participants that the determination of whether or not the injury was
caused by non-accidental means is an extremely complicated analysis and should be
undertaken in direct consultation with their supervisor until they become more
experienced. Explain that the following activities are design to familiarize them with the
process. However, they should be aware that this determination will vary on a case by
case basis as they will observe with the following two examples.
Trainer Prepared Flipchart: Prepare a flip chart in advance with the title: “An injury that
is the result of an intentional act that is committed with disregard or a substantial and
unjustifiable risk.”
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Ask the participants to identify what this phrase means to them and record their
responses on the flip chart.
Possible answers may include:
out of control,
lack of awareness,
malice or cruelty.
Explain to the participants that another way to answer the question of whether an injury
was the result of an intentional act that is committed with disregard of substantial and
unjustifiable risk is to ask the question:
Would a reasonable parent in the same situation view the intentional act as a gross or
great deviation from acceptable corporal discipline?
Gross is defined as: willful and flagrant, out of all measure, beyond allowance, not to be
excused.
Distribute Handout # 16 (Non-accidental Court Case Examples) and explain to the
participants that these cases represent actual court cases where the court considered
whether the parent’s intentional act represented a “disregard of substantial and
unjustifiable risk of severe physical injury.”
1. Assign half of the table groups to consider Case Example # 1: P.R. v. DPW
2. Ask the other half of the table groups to consider Case Example #2: F.R. v. DPW
3. Pass out flip chart paper to each table asking the participants to fold the chart in
half lengthwise
4. Ask the participants to work in their table groups to review the background
information and identify questions or activities that they would undertake to
determine whether the parent’s intentional act represented a disregard of
substantial and unjustifiable risk of severe physical injury.
5. Ask them to record their questions and responses on one-half of the paper.
6. On the second half of the paper, ask participants to record the information they
think they might gather as responses to their questions or activities that would
support a determination that the parent acted with a disregard of substantial and
unjustifiable risk of severe physical injury.
Remind the participants that the information that they are gathering comport with the Six
Assessment Domains provided on Handout # 7 especially around the domain for “the
surrounding circumstances accompanying the maltreatment.”
Case Example # 1: P.R. v. DPW
The mother acknowledged that she intentionally struck her six year old child on the
buttocks using a belt when she found the child writing on the wall. The child ran to avoid
the belt and when she turned her head the belt buckle struck the child in the eye. The
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mother stopped striking the child when the child indicated that her eye stung and the
mother applied first aid. Three days later, the child underwent surgery to remove blood
accumulated in the eye.
Case Example # 1: P.R. v. DPW
Court’s ruling: “Applying this standard to the present case, we conclude that DPW failed
to present substantial evidence that D.N. was the victim of child abuse. One can
question the wisdom of a parent’s decision to use a belt with a buckle attached to
administer a spanking. However, in most circumstances the decision to use a belt that
bears a buckle cannot be viewed as gross deviation from the standard of care a
reasonable parent would observe in the same situation. Without substantial proof that
this unusual injury was more than the regrettable result of corporal punishment, we
cannot allow the oddity of the result itself to presuppose the element of unjustifiable risk
that would lead to criminal negligence. P.R. v. Department of Public Welfare, 569 Pa.
123, 801 A.2d 478 (2002).
Case Example #2: F.R. v. DPW.
Father spanked his 10 year old son with his open hand for lying about a homework
assignment. Photograph taken a week after the incident depicted bruising widespread
across both hemispheres of child’s buttocks. During the course of the investigation child
reported that his father struck him 35 times and that on a pain scale of 0 – 10 with 10
being severe pain, that he experienced about a 10 and that he had trouble sleeping on
his backside for three days. Later when testifying, child testified that he experience a
pain level of about 8 or 9. When the father viewed the pictures, he was surprised at the
severity of the bruising and in testimony stated that he could not recall the number of
times he struck P.R.
After 10 minutes ask the participants to present their questions and answers to the
larger group. If more than one table has responded to the case example 1 and 2, ask
the subsequent groups to only report on questions and answers they identified that
were not previously identified by the first table group.
After the participants have completed their reports provide them Handout # 18 (Court
Rulings on Non-accidental Court Case Examples) and share with the courts’ rulings
in these cases.
Case Example #2: F.R. v. DPW.
Court’s ruling: The father through the intentional act of spanking caused the child to
suffer severe pain and a functional impairment based on the bruising suffered. Although
the father did not act with malicious intent he “lost control of his emotions” and caused
injuries “while disregarding a substantial and unjustifiable risk” to the child. F.R. v. DPW
(Pa. Cmwlth. 2010)
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Ask the participants to identify why they believe the courts arrived at two different
results.
Possible answers can include but are not limited to:
Different facts, different judges, or different documentation of the evidence,
Explain to the participants that several factors contributed to these outcomes. One
reason may be that in the first case example the mother, although she used a belt and
caused perhaps a more serious injury, was not found to be out of control, had
intentionally struck her child, but did not intend or arguably could have anticipated the
outcome. It also appears that the court focused on the lack of substantial evidence
regarding whether or not the injury was non-accidental which suggest that perhaps
sufficient evidence regarding this second inquiry was not available to the court. In the
second case, the father was found to have been out of control which was supported by
substantial evidence.
Explain to the participants that the second case example provides an excellent example
of how the child welfare professional provided substantial evidence to document both
the first and second inquiry. Emphasize to the participants that it is imperative that child
welfare professionals provide evidence regarding both inquiries and that the evidence
be substantial. Explain to that substantial evidence is evidence which outweighs
inconsistent evidence and which a reasonable person would accept as adequate to
support a conclusion. CPSL 6303 (a).
the participants that d. is the correct answer.
Conclude this section by emphasizing to the participants that the responsibility will be
on the child welfare professional to objectively collect information to support their
determination as to whether the different “acts of abuse” have occurred or not.
Before moving on to the next step, ask the participants if they have any additional
questions regarding non-accidental serious physical injury and the two-part inquiry.
Step 3: Examples of Physical Injuries to Children
(Lecture, Power Point demonstration)
(20 minutes)
Explain to the participants that, in this section they will view pictures that depict physical
injuries to children. Remind the participants that the pictures may cause them to have
strong emotional reactions. Ask the participants to look closely at the pictures consider
whether the injuries occurred by accidental or non-accidental means.
Bruises
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Explain to the participants that bruises from child abuse can occur on any area on the
body. However, certain locations on the body are more commonly affected because of
ready access or because of common patterns of abuse. The most common surfaces for
accidental bruising are the lower arms, lower legs, knees, and elbows. Truncal bruising
is rare, even in active children. Toddlers will often have bruises on their foreheads from
pitching forward when learning to walk.
Children who can only crawl rarely show any bruising because of their lack of muscle
strength. Any bruises in young infants who are not yet pulling to standing should raise
concerns of abuse or of an unsafe environment.
Dating bruises can be difficult. Caseworkers should not label bruises as ‘new’ or ‘old’
based on color. The color of bruises may change due to hemoglobin breakdown over
time, but there is no consistent pattern through which the colors of bruises change.
Hemoglobin breakdown is variable and based on individual differences. When there is
redness, swelling and/or tenderness, it is medically acceptable to say that a bruise is
‘acute’. When a bruise is entirely yellow and brown, it is acceptable to say that it is ‘older
than 24 hours’. However, even this is difficult to determine, particularly when children
experience repeated injuries and bruises overlap. The rate of healing of bruises
depends on:
•
•
•
•
The location of the bruise: Bruises on the face or genitals often heal faster than bruises on
other parts of the body because of the excellent blood supply in those areas. Bruises on the
shins are slow to heal because of comparatively poor blood supply.
The depth of the bruise: Deep tissue bruises in areas such as the thighs or hips may take
longer to become apparent and longer to heal.
The amount of bleeding in the tissues: Bruises resulting from large amounts of blood in the
tissues take longer to heal.
The circulatory status of the bruised area: Bruises will appear and resolve more slowly if
circulation is impaired.
Trainer Note: Display the pictures using the Power Point presentation and describe the
injuries as identified below.
Slide 1
Acute extensive facial bruising on a child who is not yet crawling.
Slide 2
Mongolian spots on the face. Mongolian spots and other birthmarks are
easily confused with bruising. Mongolian spots are especially likely to
cause concern because of their common location on the buttocks and
lower back. They can also occur on other areas of the body. Acquired
lesions will fade over a few weeks' time while birthmarks will remain
stable. The best way to differentiate birthmarks from trauma is to
document the lesion well and wait a few weeks. If the lesion fades over a
few weeks time, it is not a birthmark.
Slide 3
"Black eyes". Toddlers and young children can have bruises on their
foreheads from accidental falls. The blood from these bruises can pool
under the eyes, causing bilateral black eyes that appear alarming but are
benign. However, abusive facial injuries can also cause "black eyes".
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Slide 4
Normal bruising encountered on the lower legs of an active child
Slide 5
Unusual bruise patterns to back of legs
Trainer Note: Pattern bruising may indicate the type of implement used.
Slide 6
Belt marks. This girl has two strap marks on her back. A strap will typically
cover the curved shape of the body. This is typical of a belt whipping;
sometimes the eyelets or buckles are visible within the bruise. In this slide
the tongue of the belt can be seen in the bruise. Linear lesions can be
caused by being hit by a whip or belt.
Slide 7
Cord Marks: Looped marks are often caused by a cord doubled over and
used as a weapon.
Slide 8
Bruised Buttocks: the buttocks and lower legs are commonly bruised from
paddling of children. This child was beaten with a plastic pipe. The
outline of the pipe can be seen.
Trainer Note: Hand marks: Marks from hands often are identified on abused children.
The hand is frequently used as an instrument of force.
Slide 9
Grab marks. The oval grab marks on the arms of this infant were caused
by the fingertips of an abuser. Oval finger marks sometimes can be seen
on the arms or trunk of a shaken infant.
Slide 10
This child has a somewhat subtle slap mark. There are parallel lines
running through a fading yellow bruise. These lines represent the outlines
of fingers. One must also consider the child’s age and physical abilities
when determining the cause of an injury.
Slide 11
Identified as a human bite mark photographed with a size standard.
Ligature marks
Slide 12
Ligature marks. Ligature marks around a child's wrists or ankles may
indicate the child was restrained by being tied.
Fractures:
Fracture can be caused by accidental and non-accidental means. However, certain
patterns of fractures have come to be recognized as virtually pathognomonic (indicating
beyond a doubt) for abuse. When evaluating a fracture, consider the mechanism of
trauma and the direction of forces required to fracture the bone. Compare these factors
to the history given by the child's caretaker. Certain diseases and conditions may make
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a child vulnerable to fractures. In most cases, these diseases and conditions are
obvious on radiographs or are recognized by a diagnostic physical examination, medical
history, or family history.
Slide 13
The indication is subdural hematoma (bruised brain) which causes the
brain to swell which builds pressure within the skull, decreases blood flow
and creates potential brain damage. Abusive head trauma can be caused
by a blow to the head or a severe shaking in infants (AKA Shaken Baby
Syndrome).
Slide 14
Rib fractures - chest radiograph. Multiple, bilateral, nearly symmetric rib
fractures are present on both the lateral chest wall and in the posterior
aspects of the ribs. This baby had squeezing or pressure injuries to the
chest. The fractures are healing and show hard and soft callous,
representing fractures of different ages. Posterior rib fractures are virtually
pathognomonic of child abuse.
Slide 15
Spiral fracture of humerus -humerus radiograph. There is a comminuted
supracondylar fracture of the humerus extending to the lateral epicondyle
in this 2-year-old.
Lacerations
Slide 16
Tongue laceration. In this case, an infant was found to have a tongue
laceration. The child was not yet walking and had no teeth.
Slide 17
Frenulum tear. The mouth is not uncommonly a site of abrasions or
bruising from forced feeding. When a bottle, spoon, or other object is
forced into a child's mouth, the frenulum of the upper or lower lip or the
frenulum of the tongue may be bruised or ruptured. The frenulum of the lip
can also tear with a direct fall onto the mouth. In this slide, the frenulum of
the tongue is ruptured.
Burns
Slide 18
Immersion burn. This child has typical "stocking" burns caused by holding
the child's feet in hot water. Note the splash marks on the less severely
burned foot. The child was able to wrest that foot away from the person
holding him.
Slide 19
This burn, nick-named the “donut hole burn,” is caused by forcing the child
to sit in a tub of hot water. The buttock makes contact with the tub, forcing
the hot water away and spares that area from contact for the length of
time necessary to cause the skin to burn.
Slide 20
Hot liquid burns. This is an example of an accidental hot liquid burn.
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Slide 21
Chemical burns to the mouth. This child sustained chemical burns to the
mouth when she was forced to drink a caustic substance.
Slide 22
This 2-month old boy has a heating grate burn on his back. The shape,
degree of the burn and the location, along with the limited physical
abilities, are indicative of a forced dry contact burn. A dry contact burn is
typically a second degree burn but without blisters.
Slide 23
Cigarette burn. Cigarette burns appear as round, symmetrical burns, often
occurring in clusters. They usually show an inner circle of tissue that is
more deeply burned than the peripheral mark. The average diameter of a
cigarette burn is 8 mm.
Step 4: Identifying Reactions to Pictures of Physical Injuries to Children
Individual Activity, Large Group Discussion
(10 minutes)
Distribute Handout # 19 (Reactions to Pictures of Physical Injuries to Children),
and ask them to reflect on their emotions and reactions to the pictures that have been
presented in this section to complete the handout. After 5 minutes facilitate a large
group discussion regarding the participants’ reactions and encourage each participant
to share their reactions.
Remind the participants that it is normal to have these reactions to these pictures. It is
and should be disturbing when children are injured. Encourage the participants to
recognize that by tuning in to self and identifying their emotional reactions, they can
first, intentionally distinguish their emotional reactions from objective evaluations and
second, intentionally engage in self-care in response to their exposure to these
challenging experiences.
If a child had any injuries shown in these slides, a medical exam is warranted and the
caseworker would not be making these decisions (abuse or not) in isolation.
Step 5: Questions and Methods of Inquiry to Determine Serious Physical Injury
Small Group Activity, Large Group Discussion
(45 minutes)
Trainer Note: Step 5 is an optional exercise and may be skipped if time is at issue.
Remind the participants that to ascertain whether a serious physical injury occurred by
accidental, non-accidental or other means, they must learn to ask relevant questions
and/or employ appropriate investigative methods. Distribute Handout # 18
(Questioning) and inform the participants that this handout, which offers types of
questions to ask as well as steps for effective questioning, will serve as a guide for the
next activity.
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Display Overhead #11 (Determination of Non-accidental Serious Physical Injury) to
assist the participants with the definition of serious physical injury and non-accidental if
needed.
Using Appendix #2 (Laminated Photos (1–10), provide each table group two (2)
laminated photos, blank flip chart paper and markers. Using their respective
photographs and any other resources they see fit, ask the participants to identify
questions and/or activities that they would use to determine how the injury occurred.
After 10 minutes, ask a volunteer from each table to present their questions and/or
methods and the corresponding type of inquiry. Ask participants from other tables to
provide additional comments and feedback.
• Photo 1 This child has at least six human bite marks on his back. It was
reported that they were caused by a sibling. Whether or not that is
true could be determined by taking measurements and teeth
patterns to determine who caused them. One might question the
quality of supervision even if they were caused by a sibling.
• Page 2
Loop marks on the skin are often caused by hitting with a doubled
over electrical cord, rope, or fan belt. If the skin is broken, scarring
is very common.
• Photo 3 Slap mark. This slap mark on an infant’s cheek was caused by a
human hand. The outline of fingers is seen.
• Photo 4 These are grabbing or squeeze marks. The oval-shaped, pressure
bruises on the child’s arm are actually fingerprints from being
forcibly held during a violent shaking.
• Photo 5 Ligature marks around the child’s lower legs may indicate that the
child was tied.
• Photo 6 Lip injury. Injuries to the inside of the lip can be from accidental
falls, from direct blows to the mouth, or from putting a hand over a
child’s mouth in an attempt to quiet or suffocate the child.
• Photo 7 The most common inflicted burns seem to be caused by a
cigarette. They are circular, punched out and of similar size. They
can vary in the degree of burn they caused based on the length of
time the cigarette was kept in contact with the skin.
• Photo 8 Grid Burn. In any injury, the history given for the injury is
compared with the injury observed when evaluating the child for
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possible abuse. In this case, the history given was that the 2 year
old stepped on a floor gas heater with both feet. On the one hand,
it seems unlikely the child would have put his second foot down
after experiencing pain in the first foot when exploring the surface.
On the other hand, he may have put the second foot down quickly
in response to the pain caused by the burn on the first foot. No
determination was made in this case as to whether or not the
burns were caused by abuse.
• Photo 9 Immersion burn. Immersion burns are the most common burns
caused by child abuse. In this case, the burn has a typical "glove"
distribution caused by the hands being dunked in very hot water.
No splash marks are noted.
• Photo 10 This slide shows an acute, angulated, transverse fracture of the
femur in a nine-month-old child. The caretaker explained the child
got her leg caught in the crib rail. The story given is inconsistent
with the amount of force necessary to cause the fracture. On
skeletal survey, a skull fracture was found. A young child with a
severe injury is at a high risk of having been abused other times or
of being abused in the future.
Possible responses include but are not limited to:
Serious physical injury:

Take a picture of the injury.

Objectively evaluate the seriousness of the injury and the existence of temporary
or permanent impairment.

Obtain a medical professional’s opinion regarding the seriousness of the injury.
Severe pain:

Obtain a medical professional’s opinion regarding the amount of pain associated
with a particular injury. (Note: The child welfare professional determines the
finding based on the opinion, the opinion is not the finding.)

Observe or obtain observations of the child’s behavioral response to the injury.

Ask the child how the injury felt.

Ask the child a scaling question (1-10, with 1 being the least painful, to 10 being
the most painful).
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
Ask the child comparison and duration questions such as compare pain to
previous injuries, known to have been severely painful and length of time the
pain was experienced.

For a young or non-verbal child, obtain observations regarding if the child cried,
and for how long he/she cried.
Non-accidental:

Ask the parent the circumstances under which the injury occurred.

Ask the parent’s specific intent if the circumstances involved an intentional
striking.

Objectively consider whether a reasonable parent would engage in the same
actions under the same circumstances.

Obtain medical opinion regarding the how the injury may have occurred.
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Section IV: Understanding Family Dynamics and Behavior in Child
Maltreatment
(1 hour and 35 minutes)
 After being provided information regarding the pre-conditions of abuse, the
participants will be able to develop a scenario that depicts an example of one of
these pre-conditions.
 When viewing video testimony of parents regarding their abusive conduct
towards their children, the participants will correctly identify markers for
preconditions of child maltreatment.
.
Lecture, Small Group Activity, Video, Large Group Discussion
Materials Needed:
 Flipchart stand
 Colored markers
 Masking tape
 Handout #20 (Impact of Physical Abuse on Children’s Behavior and
Development)
 Handout #21 (Parental and Family Conditions of Abuse)
 Overhead #13 (Conditions of Abuse)
 Video: Scared Silent
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Section IV: Understanding Family Dynamics and Behavior in Child
Maltreatment
Step 1: Impact of Physical Abuse on Children’s Behavior and Development
Lecture
(10 minutes)
Explain to the participants that the experience of physical abuse and other forms of child
maltreatment will have an impact of both children’s behavior and development.
Variables such as the age of the child at the onset of the abuse and duration of the
abuse also will affect children’s response.
Distribute Handout #20 (Impact of Physical Abuse on Children’s Behavior and
Development) and briefly review the behavioral responses of children who have been
physically abused based on the variables provided.
Step 2: Pre-conditions of Child Maltreatment
Lecture
(15 minutes)
Explain to the participants that is very important to understand the conditions under
which a parent or caretaker behaves in an abusive fashion towards a child. Emphasize
that it would be an error to dismiss parents who have engaged in abusive behavior as
evil or malicious. Often the parent who has engaged in this conduct has experienced
numerous life challenges or conditions or possessed certain characteristics that served
to minimize the parents’ ability to take protective action on behalf of their child and led to
the abusive behavior to occur.
Ask the participants to identify possible conditions and personal characteristics of
parents that might led them to engage in abusive behavior. Possible responses may
include but are not limited to:
Conditions:
• Low income;
• History of child maltreatment in childhood;
• Exposure to violence and/or domestic violence;
• Social Isolation ;
• Absence of Family Support.
Characteristics:
• Youth or developmentally immature;
• Unmet personal and interpersonal needs;
• Lack of Trust;
• Substance abuse or addiction;
• Low self-esteem and little confidence in their own abilities;
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•
Perceive the world as threatening and dangerous.
Explain to the participants that these conditions and characteristics may lead to the
parent having diminished protective capacities, and may, ultimately lead to abusive
behavior. The developmental outcomes of abuse and neglect can predispose a parent
to have diminished protective capacities and become abusive and neglectful. However,
emphasize to the participants that not all parents who were maltreated as children
maltreat their children.
Describe for the participants the four conditions that Dr. Brandt Steele suggests must be
present for abuse to occur. Display Overhead #13 (Conditions of Abuse) and discuss
the following:
•
•
•
•
The parent must have the predisposition to abuse his/her children. This
predisposition is often related to the psychological residues of neglect or abuse in
his/her own early life.
The maltreated child is perceived by the parent as being in some way different
and usually, unsatisfactory.
There must be a crisis of some sort in the family, or circumstances that place
added stress on the parent.
The parent may not have sources of external support. Many parents have
created a self-imposed isolation and fail to reach out for help; or, adequate
supports and resources are not available to the parent.
Trainer Note: Inform participants that in Module 4: In Home Safety Assessment and
Management, they will learn more about protective capacities and exploring six
Domains to understand how the family and specifically the caregivers function and
protect the children in their care. These domains guide the worker to explore the
potential outcomes of Brandt Steele’s conditions.
Step 3: Identifying Pre-conditions for Child Abuse
Large Group Activity
(20 minutes)
Inform the group that they will now identify some examples of pre-conditions for child
abuse.
Trainer Note: In advance of this activity, prepare four flip chart papers with four
different headings identified below. Hang the prepared flip chart paper up in the room
and assign each table group to a condition. Allow the participants 5 minutes to list
examples of those conditions. The trainer may wish to introduce a competitive element
and offer a small token to the table or group with the longest list.
•
•
•
Heading 1: The parent’s predisposition to maltreat his/her children;
Heading 2: The child is seen as “difficult” and “unworthy”;
Heading 3: Stress and Crisis in the Family; and
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•
Heading 4: The absence of supports.
While still standing, ask a representative from each table group to review their list. Ask
the other participants if there is anything they would like to add to each other’s lists.
Ask the participants to return to their seats and distribute Handout #21 (Parental and
Family Conditions of Abuse) and review briefly with the participants any examples or
concepts that were not already covered by the participants in the previous activity.
Step 4: Scared Silent
Video, individual activity, large group activity
(50 minutes)
Inform the participants that they will view a 20-minute video, Scared Silent, which
consists of three parents providing testimonials regarding their personal experience with
child abuse. Ask the participants to consider the feelings of the parents by “tuning in to
others”. Encourage the participants to take notes during the video to identify examples
of Brandt Steele’s four pre-conditions of abuse and decreased parental capacities.
Refer the participants to Handout #21 (Parental and Family Conditions of Abuse), to
assist them in identifying these pre-conditions.
Explain that the first presentation is from Jill, a woman who was acquitted of murdering
her toddler and recounts her own experience with child abuse.
The second presentation is from George who acknowledges physically and emotionally
abusing his five children, who became an advocate and speaks all over the country
about how child abuse impacts the family.
The third presenter is Beatrice who physically abused her 2-year-old daughter Roxanne;
the child sustained a broken leg. She obtained treatment in a community parenting
skills program.
The video also includes testimonials from adults and children regarding their experience
with emotional abuse.
After presenting the Video (Scared Silent) engage the participants in a large group
discussion regarding their observations of the four pre-conditions of abuse that were
apparent in the parents’ testimonials.
Some of the discussion points may include:
 The parent’s predisposition to maltreat his/her own children:
• In George’s story, he was abused as a child. He said he did not learn positive
parenting techniques to use with his own children.
• Beatrice reported she also was abused as a child and was raised without
developing a healthy self-esteem.
• Jill traces her abusive family history back for five generations.
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 The child is seen as “different or unworthy”:
• George reports that he thought he needed to be strict with his children in
order to prevent them from getting out-of-control.
• Beatrice saw her own child as causing her unmanageable levels of stress.
• Jill reports she was preoccupied with keeping a perfectly clean house and lost
control when her two children caused a mess with potato chips.
 Stress and crisis in the family:
• George does not identify significant stressors other than not knowing any
other way to parent.
• Beatrice reports she was a single mother and seemed to be poor and raising
several young children without any family supports.
• Jill’s crisis was caused by the need to keep the house in perfect order and
she got overly stressed when the children made a mess after she worked so
hard to clean the house.
 The absence of supports:
• George seemed to feel responsible for the whole family; there is scant
mention of his wife’s role, other than that his control of the children seemed to
extend to excessive control over her as well.
• Beatrice appeared to be a single mother with several small children. She was
without extended family support.
• Jill seemed to have a “perfect” family in an affluent neighborhood. She was
socially isolated and seemed to have no outside or familial support.
Remind the participants that Dr. Brandt Steele’s conditions of abuse: parent’s
predisposition to abuse, parent’s abuse as a child, a crisis in the family, and no external
support, are excellent indicators of current or future abuse. Child welfare professionals
should be looking for these conditions when working with families. If one or more of the
conditions are present in the family, the child welfare professional must explore the
existing conditions and consider them when evaluating the child’s safety, permanency,
and well-being.
Ask the participants to retrieve Handout # 3 (Idea Catcher/Action Plan) and ask them
to identify those concepts they would like to capture and write down their action plans
for implementing them.
Inform the participants that this section concludes the first day of Module 2 and ask if
there are any questions or concerns before ending the session.
Trainer Note: This is the end of day 1 of Module 2.
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Section V: Child Sexual Abuse
(2 hours)
 Recognize the definition of sexual abuse as defined in the Child Protective
Service Law;
 Recognize the physical and behavioral indicators of sexual abuse; and,
 Recognize cultural differences, beliefs, and parenting styles can add both clarity
and complexity to the situation.
Lecture, Small group activity, Large Group Discussion
Materials Needed:
 Flipchart stand
 Colored markers
 Masking tape
 Handout #22 (Sexual Abuse Definitions)
 Handout #23 (Physical and Behavioral Indicators of Sexual Abuse)
 Handout #24 (Indicators of Sexual Abuse)
 Handout #25 (Childhood Sexual Behavior Activity)
 Handout #26 (Behaviors Related to Sex and Sexuality in Children)
 Handout #27 (Child Sexual Abuse Questions)
 Overhead #14 (Definition of Sexual Abuse)
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Section V: Child Sexual Abuse
Step 1: Review of Previous Day and Preview of Day 2
Lecture
(5 minutes)
Welcome the participants to the second day of Module 2 and review with them briefly
the content areas that were presented on Day 1. Ask the participants if they have any
questions about yesterday’s content. Display Overhead #2 (Agenda) and preview the
agenda for Day 2 material.
Step 2:
Lecture
(10 minutes)
Trainer Note: Participants may express discomfort, embarrassment or indignation
regarding the content and activities in this section. Remind the participants that it is
essential to effective child welfare practice that they overcome their reactions to the
topic of sexual behavior normal, abnormal and abusive if they intend to build protective
partnerships with parents, a rapport with abused children and effectively identify or
provide services in child sexual abuse.
Ask the participants to say the word SEX. Ask them to repeat it a second time. After
waiting a few seconds ask them to say SEX for a third time. Inform the participants that
in our society sex is something you are taught to talk about in private. It certainly is not
something you talk about in public or with strangers. Sex is something that is meant to
be pleasurable between consenting adults. It certainly is not something that is meant to
be abusive to children. No one wants to even think that a child could be sexually abused
– but sadly, it is all too true.
Explain to the participants that child sexual abuse is a pervasive problem in the United
States and provide them the following statistics provided by the National Children’s
Alliance (www.nationalchildrensalliance.org)
•
•
•
1 in 4 girls and 1 in 6 boys will be sexually abused before the age of
18. (ACE study, www.cdc.gov)
Nearly 70% of all reported sexual assaults are on children ages 17 and
under. (U.S. Dept. of Justice, 2001)
There are 40 million survivors of child sexual abuse in America today.
(F. Putnam, 2003)
In 2009, Pennsylvania Child Sexual Abuse Statistics were:


Sexual abuse was involved in 51 percent of all substantiated reports;
Sixty-six percent of the substantiated victims were girls, 34 percent were
boys;
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


The higher number of substantiated reports involving girls is partially
explained by the fact that 80 percent of sexual abuse reports, the most
prevalent type of abuse, involved girls and 20 percent involved boys;
Fathers (20 percent) and other family members (21 percent) caused the
most sexual abuse injuries
Most of the abuse committed by a babysitter was sexual abuse,
comprising 86 percent of the total abuse by a babysitter. Inform the
participants that Module 2 provides a brief overview and beginning level of
knowledge and skills for assessing family dynamics in child sexual abuse.
After completing the Charting the Course Towards Permanency for
Children in Pennsylvania, it is recommended that they register for the five
day Sexual Abuse Series Certificate Program offered by the Child Welfare
Training Program which includes:
1. Overview of Child Sexual Abuse.
2. Sexuality of Children: Healthy Sexual Behavior and Behaviors Which Cause
Concern.
3. Investigative Interviewing in Child Sexual Abuse Cases.
4. Working with Juveniles who Sexually Offend.
5. Family Reunification and Case Closure in Child Sexual Abuse Cases.
Step 3: Increasing Comfort with Sexual Terms
Lecture, Activity
(20 minutes)
Ask the participants to think of the most embarrassing uncomfortable experience they
had with sexual intimacy and to think about it for one minute. Caution the participants
not to share this experience, but rather think about how they would feel if they were then
required to share this experience with a complete stranger. Ask the participants to
identify the words that describe their feeling about sharing this intimate information and
record these words on flip chart paper.
Ask the participants to identify the feelings that children might have if they were required
to share intimate information about a sexual experience. When recording those words
on the flip chart, use a different color marker and record any similar words identified in
response to the first question next to the those words.
Now ask the participants to identify how they might feel if the person they shared their
intimate experience with either laughed, giggled, cried, chastised or criticize when
responding to the information and record those responses on another flip chart paper.
Ask the participants to identify how a child in a similar situation might feel. Again using a
different marker record the participants’ responses in a similar manner as described
above.
Trainer Note: The trainer might wish to encourage a competitive response by offering a
prize for the group that can identify the greatest number of words in 5 minutes.
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Pass out flip chart paper to each table group and ask them to record all the words that
they can think of that a child (of any age) might use when describing a private body part
or a sexual encounter in five minutes.
After five minutes ask the participants to hang their completed flip charts in the room
and for a volunteer from each table group to read their list, skipping any terms that were
identified by the previous group.
The trainer should model comfort with the terminology by repeating some of the words
without embarrassment and when appropriate with some light humor.
Once each table group has participated explain to the participants that we all have
different comfort (or discomfort) levels with the topic of sex and terminology. However,
child welfare professionals will be required to have open and frank discussions about
intimate behavior with parents, children, lawyers, doctors, nurses, and judges.
Therefore, child welfare professionals must become comfortable and relaxed with the
language to communicate effectively with each of these individuals. They always must
use the language and terminology used by a victim, child, adult, parent, or perpetrator.
Changing the language that a child uses for instances could have disastrous results in
an investigation or a court hearing.
When they are unsure of a person’s meaning, they must become comfortable with
asking for clarification. For example, if a parent says “my daughter told me the baby
sitter touched her “box.” An appropriate response would be: “What do you mean by a
box?” If the parent responds by saying her “snatch” you need to continue to ask what
part of her body do you mean? The child welfare professional should never assume a
meaning of any word.
Summarize the activity by informing the participants that the intent of this activity was to
provide them an opportunity to practice using the terms with their peers in a safe
environment. Encourage the participants that if any of them continue to be
uncomfortable they should continue to practice with a friend, co-worker, or supervisor
before attempting to conduct an actual interview.
Trainer Note: Due to the sensitive nature of the flipcharts generated by the above
activity, the trainer must be sure to dispose of the flipcharts appropriately.
Step 4: Pennsylvania’s Definition of Child Sexual Abuse
Lecture
(15 minutes)
Display Overhead #14 (Definition of Sexual Abuse) and review with the participants
definition of sexual abuse from Pennsylvania’s Child Protective Services Law:
An act or failure to act by a perpetrator, which causes sexual abuse or sexual
exploitation of a child less than 18 years of age.
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Sexual abuse or exploitation is defined as:
• The employment, use, persuasion, inducement, enticement or coercion of any
child to engage in or assist in any sexually explicit conduct; or
• The employment, use, persuasion, inducement, enticement or coercion of any
child to engage in or assist another individual to engage in simulation of
sexually explicit conduct for the purpose of producing visual depiction, including
photographing, videotaping, computer depicting and filming; or
• Rape, sexual assault, involuntary deviant sexual intercourse, aggravated
indecent assault, molestation, incest, indecent exposure, prostitution, sexual
abuse, or sexual exploitation.
Trainer Note: Since the term “recent” is not found in the CPSL at section 6303 (b)
ChildLine will accept reports alleging child sexual abuse on individuals over the age of
18 as long as the abuse occurred prior to the victim’s 18th birthday. If the victim is over
the age of 20 when the report is made, the report will be referred to the County District
Attorney where the alleged abuse occurred. If there are concerns about safety of any
children (i.e. alleged perpetrator has access to children), the report will also be
forwarded as a General Protective Services (GPS) report so the county can follow-up to
assess the safety of the children.
Act 179 of 2006 expanded the Judiciary Code (Title 42 Pa.C.S.) to allow for criminal
prosecution against individuals who commit a sexual offense against a minor who is
less than 18 years of age up to “the later of the period of limitation provided by law after
the minor has reached 18 years of age or the date the minor reaches 50 years of age.”
Since criminal charges can be filed up to the victim’s 50th birthday, ChildLine accepts
reports that fall under this and refers them to law enforcement officials and the county
agencies to assess safety of any other children.
the participants that b. is the correct answer because recent does not apply to child
sexual abuse.
Engage the participants in a discussion regarding what constitutes child sexual abuse.
Ask participants to give some examples of how children are sexually abused. Refer
participants to Handout #22 (Sexual Abuse Definitions), which was developed from
the definitions in the CPSL and the Pennsylvania Crimes Code, for the legal definitions
of sexual crimes in Pennsylvania. Provide an overview of the handout.
Remind participants that for children and youth services to investigate the case as a
sexual abuse case, the child must have been/be under the age of 18 when the abuse
occurred and the alleged perpetrator must meet the CPSL definition of perpetrator.
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Step 5: Cultural perspective in Child Sexual Abuse
Lecture, large group discussion
(5 minutes)
Explain to the participants that child welfare professionals must consider cultural
perspectives and experiences when identifying child sexual abuse or when providing
services. A cross-cultural perspective can add clarity and complexity to an investigation.
For example, in some cultures, sharing food in certain situations may constitute incest,
while other behaviors considered child sexual abuse in the United States may be
cultural norms in other countries. Child sexual abuse is an act that most often takes
place secretly in extremely private situations (as contrasted with an adult’s loss of
temper and spanking a child in a grocery store). The degree of secrecy is an important
factor in multicultural situations as well. For example, a Vietnamese mother’s stroking
of her 2-year old child’s genitals in a living room with company present can be viewed
as a culturally acceptable means of showing affection to a child. In some Latino
cultures playing with the male child’s genitals also may be viewed as showing affection
and happiness of having a male child.
Read each scenario to the participants and then ask for their responses as it may relate
to cultural situations.
Scenario 1: Kissing: the adult gives the child lingering or intimate kisses, particularly in
the mouth and perhaps with the adult’s tongue in the child’s mouth.
• behavior may be difficult to define as abusive without knowing more about the
context within it takes place
• families differ: some may proscribe kissing other family members in the mouth.
Others don’t.
• need more information about how long the kiss lasts and what feeling the child
has about it before making a judgment about its abusiveness.
Scenario 2: Fondling, in which an offender touches, caresses, or rubs a child’s genitals
or breasts, or has the child similarly touch his/her body.
• Fondling may occur in the context of some other activity such as bathing or
reading a story to a child. In this case the adult uses the context to be close to
the child, and uses the closeness to rub against the child’s body.
• If the purpose is to relax the child, communicate support, or otherwise share
positive emotions with the child, then it is not abusive.
Note the use of the term for sexual gratification, (the word in the Pa. Crimes code is
arousing or gratifying sexual desire) and ask the participants if they have any idea why
such a term would be necessary. The reason goes back to the purpose of the law,
which is not to set a value or standard, but rather to protect children from harm. Use the
following question and answer to make the point; ask the participants to raise their
hands if they have a child or children to put up their hands. Ask them to keep their
hands raised if they have any pictures of their child naked, at any age, under any
circumstances. Inevitably, most hands will remain up. Continue by asking the
participants why they have such pictures, and they will certainly give common,
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acceptable reasons. Therefore, they are not engaging in child pornography. If they used
such pictures for arousal or for someone else’s use for arousal, then it would be for
sexual gratification, and therefore, sexual abuse. You may continue the same process
by asking them if they have ever, at any age, touched their child’s private parts and
follow the logic as the previous question.
Step 6: Physical and Behavioral Indicators of Child Sexual Abuse
Lecture
(15 minutes)
Explain to the participants that child sexual abuse includes a wide range of behaviors
and activities. A challenge is that, unlike physical abuse that often leaves physical signs
physical signs are present in only about 10 percent of child sexual abuse findings.
Distribute Handout #23 (Physical and Behavioral Indicators of Sexual Abuse),
review the possible physical indicators of sexual abuse and inform the participants that
child sexual abuse can be medically confirmed in only a minority of cases, even with
physical evidence such as a sexually transmitted disease in a young child. This lack of
medical confirmation also is true when penetration has taken place. In cases where
child sexual abuse cannot be medically confirmed because of lack of physical evidence,
child welfare professionals need to complete a comprehensive psychosocial and family
assessment including safety and risk assessments to substantiate child sexual abuse.
In addition to the child welfare professional gathering basic information from the child,
the parent/caretaker, the alleged perpetrator, and other household members, an indepth evaluation by a professional who specializes in child sexual abuse may be
necessary to determine the existence of child sexual abuse and the emotional harm to
the child. The child welfare professional must remember that children and youth
services has the final authority to make a determination about the veracity of a child
sexual abuse case therefore the collection of evidence to support children and youth
service’s finding is important.
Inform the participants that although there are often no medical findings, medical exams
are recommended. Child welfare professionals often are reluctant to make such a
referral out of concern that the exam may re-traumatize the child. Some professionals,
however, advocate that the medical exam can alleviate the child’s and his or her
caregivers’ fear that the child has been permanently damaged. In other words, negative
findings become positive.
As stated above, often times there are not any physical indicators of sexual abuse.
Therefore, one must be aware of the behavioral indicators. Distribute Handout #25
(Indicators of Sexual Abuse), to review the possible behavioral indicators of sexual
abuse.
Caution the participants that a significant number of these factors also would be present
in the non-abused population of children (like bed-wetting or nightmares.) Some of
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these behaviors also may be symptomatic of non-sexual/non-abusive problems, which
may indicate the need for professional therapeutic intervention. Other factors are highly
associated with child sexual abuse and can be weighted more heavily. For instance,
sexual knowledge and behavior beyond the developmental level of the child and/or
compulsive masturbation or other sexual acting-out behaviors should be looked at
carefully. The correlation between these behaviors and sexual abuse is relatively high.
Another high-probability indicator is any attempt by a child to verbalize that they are
being or have been sexually abused. For some of the other behaviors, the correlation is
relatively low. Therefore, child welfare professionals need to carefully evaluate behavior.
Ask participants if there are indicators they think should be added to this list.
Participants may notice the absence of fire-setting and cruelty to animals on the list. If
they do not point out these behaviors, inform the participants that many professionals
are identifying a correlation between fire setting and sexual abuse, as well as sexual
manipulation or cruelty to animals.
Step 7: Child Sexual Abuse and Child Development
Small Group Activity, Large Group Discussion
(40 minutes)
Distribute Handout #25 (Childhood Sexual Behavior Activity) and Handout #26
(Behaviors Related to Sex and Sexuality in Children) and explain to participants that
they are going to practice identifying appropriate and inappropriate sexual behavior
based on various age groups. Ask the participants to refer to Handout #23 (Physical
and Behavioral Indicators of Sexual Abuse), Handout #24 (Indicators of Sexual
Abuse) and Handout #26 (Behaviors Related to Sex and Sexuality in Children) as
reference tools.
Using pages 1 and 2 of Handout # 25 (Childhood Sexual Behavior Activity), assign
each table group one scenario from each age group. For example, have group 1
answer all of the questions #1’s, group 2 answer all questions #2’s, etc.
Each table group must answer the following questions on the handout for the situations
assigned to them.
 Identify if the behavior is:
• Appropriate;
• Of concern; or
• Needs immediate professional intervention.
 If the behavior is appropriate, determine what inappropriate behavior would be.
 If the behavior is inappropriate, determine what appropriate behavior would be.
Each small group should select one situation to present to the larger group.
Trainer Note: List the following bulleted questions on a prepared flipchart or
PowerPoint.
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Give participants 15 minutes to complete the exercise and then engage the participants
in a large group discussion. Ask each table group the following questions:
• Which age group did you choose?
• Read the scenario.
• Was the behavior appropriate or inappropriate?
• Did the behavior concern you? Why?
• Is there a need for professional intervention?
• What kind of intervention?
The trainer should identify these important points if the participants do not identify them
in their presentations:
•
•
•
•
The first indicators of sexual abuse may not be physical signs or complaints, but
behavioral changes or abnormalities.
Behavioral changes can be different depending upon the child’s age;
These behaviors may occur in other children with no history of child sexual
abuse;
The absence of any or all of these behaviors does not rule out sexual abuse.
Trainer Note: The trainer should briefly review the content of Handout #24 (Indicators
of Sexual Abuse) when processing out this exercise.
•
•
Toddlers and young children (ages 2 to 5).
(1) Fear of a particular person or place.
(2) Regression to earlier forms of behavior such as bed-wetting,
stranger anxiety, separation anxiety, thumb-sucking, baby talk,
whining, fear of abandonment, and clinginess.
(3) Sexualized behaviors with other children.
(4) Unusual mood swings, temperament changes, excessive sadness,
or loss of interest in age-appropriate activities.
(5) Feelings or expressions of shame, low self-esteem, or guilt.
(6) Excessive masturbation.
(7) Cruelty to animals.
(8) Fire-setting.
Six- to eight-year-old children. Any of the above symptoms or changes
and/or:
(1) Nightmares and other sleep disturbances.
(2) Sexualized behaviors with other children or directed towards adults.
(3) Sexually inappropriate or graphic language or drawings.
(4) Phobias about specific school or community activities, places or
people.
(5) Withdrawal from family and friends and previously enjoyed activities
(6) Regressive behaviors.
(7) Eating disturbances.
(8) Physical complaints such as abdominal pain or urinary or bowel
difficulties.
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•
•
Preadolescents (10 to 12 years). Any of the above symptoms or changes
and/or:
(1) Depression, anxiety, mood swings, unusual anger or aggression.
(2) Nightmares and other sleep disturbances.
(3) Poor school performance.
(4) Sexualized behaviors with other children or directed towards adults.
(5) Sexually inappropriate or graphic language or drawings.
(6) Promiscuity.
(7) Pregnancy.
(8) Use of illegal drugs or alcohol.
(9) Fear that the abuse will reoccur (Post Traumatic Stress Disorder
symptoms).
(10) Eating disturbances or disorders such as anorexia.
(11) Regression to earlier behaviors.
(12) Withdrawal from family and friends or previously enjoyed activities.
(13) Suicidal thoughts, gestures, or attempts.
Early adolescents (13 to 15 years). Any of the above symptoms or
changes and/or:
(1) Running away from home.
(2) Depression.
(3) Promiscuity or prostitution.
(4) Recurrent physical complaints.
(5) Pregnancy.
(6) Use of illegal drugs or alcohol.
(7) Suicidal thoughts gestures or attempts.
(8) School truancy.
(9) Poor school performance.
(10) Fear that the attack will reoccur (Post Traumatic Stress Disorder
symptoms).
(11) Anger and rage about being forced into a situation beyond one’s
control or with attempted disciplinary action by a parent or caregiver.
(12) Withdrawal from family and friends or previously enjoyed activities.
Discuss the following regarding early adolescents:
•
•
•
•
•
The developmental work of this stage of development involves learning to
develop close relationships with others.
This stage of development requires the refinement of social skills with their
peers and others; and
Teens usually distance themselves from parents during this stage of
development;
The most common type of sexual behavior in this age group is
masturbation.
Because of the physical changes of puberty, teens develop greater
purpose and control of their activities.
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•
•
•
•
•
•
•
•
Teens are intensely interested in viewing others’ bodies, especially the
opposite sex and the bodies of adults.
Teens may seek out sexual materials--pictures, magazines, and videos,
some of which may be pornographic.
Teens sometimes may initiate group peeks at the opposite sex- --in locker
rooms for example.
Teens often explore interactive sexual behaviors. This ranges from open
mouth kissing and fondling or rubbing each other’s breasts or genitals to
simulating intercourse, to various types of behaviors that involve sexual
penetration. Most often this is with a partner of the opposite sex but same
sex activity occurs often as well. It is important to note that the behavior is
with peers.
Usually, preadolescent and adolescent boys and girls do not meet their
social needs with younger children.
Most teens will not seek out the company of, or voluntarily choose to
spend significant amounts of time with, younger children.
There are individual differences in every age group.
Teens can truly enjoy the company of young children in a healthy,
nurturing way.
Step 8: Child Sexual Abuse Question
Large Group Discussion
(10 minutes)
Distribute Handout #27 (Child Sexual Abuse Questions) and engage the participants
in a large group discussion regarding each question. Suggested answers are below:
1. Question
• During a home visit you observe a 3-year old male fondling himself. Do you
suspect he has been sexually abused?
Answer
• No, it is normal developmental behavior for a three-year-old male to fondle
himself.
2. Question
• You are providing on-going services to a family who has moved around and
lived with lots of different people. The day care teacher reports that she has
observed 4-year-old Susie frequently masturbating herself, the dolls and
humping on the teddy bear.
A. Does this child need a further assessment for possible victimization?
B. Would this report be accepted as a child abuse investigation?
Answer
A. Yes, the child is displaying obsessive sexual behavior beyond what is
developmentally age-appropriate for a 4-year-old female. She needs to be
assessed by a professional.
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B. No, This would not be accepted for as a CPS investigation, as there is not
a specific report/allegation of abuse, however further safety assessment may
be needed and the case may be accepted under the General Protective
Services guidelines.
3. Question
• A father reports that his 17-year old extremely cognitively limited daughter
(developmental age 5) came home crying because a “boy” had sex with her.
Would this be accepted as a child sexual abuse investigation?
Answer
• No, the “boy” that allegedly had sex with her does not meet the definition of
perpetrator as defined in the CPSL. However, Children and Youth Services
should refer the matter to the appropriate police department.
4. Question
• A neighbor calls to report that the woman next door is “taking advantage” of
her 8-year-old son. Specifically, he still sleeps with her at night. Would this
case be accepted for a child sexual abuse investigation?
Answer
• No, it is not illegal to sleep with your child. There is no data that indicates that
the mother is doing anything for her own sexual gratification. People have
different values regarding children sleeping in their own beds.
5. Question
• A teacher reports that she learned her 14-year old female student is having
consensual sex with her 15-year old brother. Would this case be accepted for
investigation?
Answer
Possibly. A few factors may influence decision making in this scenario.
Information about the brother’s status as a household member must be
determined. The parents of the children could be named as perpetrators by
omission if they were aware of the sexual relationship and did not intervene.
Additional information would need to be known about which child initiated the
sexual contact. Ultimately, further assessment would be needed and the
case would be accepted under the General Protective Services guideline,
and potentially changed if information obtained qualified the matter as a
CPSL sexual abuse investigation.
6. Question
• A 12-year-old female admits she is fondling her one-year old brother. Is this
investigated for child sexual abuse?
Answer
• Depends, is the 12-year-old the caretaker of the one-year old when the abuse
is occurring? If so, yes, it is investigated. Another possibility is that the
parents could be named as perpetrators by omission for not providing
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•
adequate supervision. The 12-year old should be assessed to determine her
own victimization.
An assessment is needed and the case would be accepted under the General
Protective Services guidelines.
7. Question
• School reports that an eight-year-old boy brought pornographic pictures to
school. When he was talking to the teacher, he said he gets the pictures from
his uncle and they watch “dirty” movies together when his uncle baby sits.
Would this be accepted for child sexual abuse?
Answer
• Yes, the uncle is a caretaker and the child is too young to be exposed to
pornographic material.
Conclude this section by stating that it is important for child welfare professionals to be
aware that there is not a specific situation or pre-condition that dictates that child sexual
abuse will occur. It is the role of the professional to be observant and listen to clues that
may be provided by children and the adults around them. Discussing sexual topics is
very difficult and often, people do not state their concerns directly. Yet, do not
automatically assume that because a child displays one or two concerning behaviors
that he or she has been sexually abused.
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Section VI: Imminent Risk
40 minutes
 Recognize the definition of imminent risk as defined in the Child Protective
Service Law.
Lecture, Small Group Activity, large Group Discussion
Materials Needed
 Flipchart stand
 Colored markers
 Masking tape
 Handout #28 (Imminent Risk)
 Handout #39 (Case Scenarios)
 Overhead #15 (Imminent Risk)
 Overhead #16 (Substantiating Imminent Risk)
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Section VI: Imminent Risk
Step 1: Defining Imminent Risk
Lecture
(10 minutes)
Distribute Handout #28 (Imminent Risk) and review with the participants by explaining
that the Child Protective Services Law (CPSL) defines imminent risk as any recent act,
failure to act or series of such acts or failures to act by a perpetrator, which creates an
imminent risk of serious physical injury to or sexual abuse or exploitation of a child
under 18 years old.
Using Overhead #15 (Imminent Risk), explain that imminent means “ready to take
place” so the time frame for consideration is the time during or immediately following the
act or failure to act. Risk may be defined as a dangerous element or factor.
Imminent risk or physical abuse situations occur when a child is demonstrably at-risk,
but for happenstance, third party intervention, or an action of the child, serious injury
would have occurred and the injury would have been serious and/or caused severe pain
or would have impaired the child’s physical functioning but the injury did not actually
occur. An example is (1) that a chair is thrown at a child and the child ducks at the final
moment and the legs of the chair are implanted into the wall (2) a father is dangling his
6 months old child from a hotel balcony, and because someone makes him bring the
baby in, the child is not injured.
For alleged imminent risk of sexual abuse or sexual exploitation: (1) there must be
substantial evidence that an action on the part of the alleged perpetrator placed the
child at imminent risk of sexual abuse/exploitation; or (2) there must be substantial
evidence that the alleged perpetrator had known or should have known of the risk of
sexual abuse and failed to exercise reasonable judgment in preventing such risk.
Using Overhead #16 (Substantiating Imminent Risk) explain to the participants that
to substantiate an act or failure to act as imminent risk, several findings must be made:
• The victim must be a child under age 18 and there must be an identified perpetrator.
• The act or failure to act must be non-accidental.
• The allegation must pertain to serious physical injury or sexual abuse or exploitation.
Serious mental injury and serious physical neglect do not apply.
• It must be a recent act. In other words, it must have occurred within two years of the
date of the report.
• A specific act or failure to act must have taken place and must be documented. It is
not enough to say that a parent’s skills are so poor that the child is at-risk merely by
living with the parent. That child may be at high risk and may be eligible for general
protective services, but it is not abuse. Look to identify the specific act or failure to
act.
• The risk of abuse must be imminent: (1) for serious physical injury, imminent means
during and/or immediately following the act or failure to act, (2) for sexual
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abuse/exploitation, imminent means the specific time frame during which the child
was exposed to risk of such abuse.
What occurred or failed to occur has to be of such force or gravity that one can
reasonably assume that should the act have come to fruition, abuse would have
occurred. Not could have occurred, but would have.
What would have happened must fit the criteria for that type of abuse. Children are in
imminent risk of serious physical injury or in imminent risk of sexual abuse or
exploitation.
In case of imminent risk of serious physical injury, what would have occurred would
have to cause the child severe pain or temporarily or permanently impair his/her
functioning. An example of imminent risk of sexual abuse is leaving a child alone with a
known perpetrator of sexual abuse.
Step 2: Determining Imminent Risk
Small Group Activity
(30 minutes)
Distribute Handout #29 (Case Scenarios), blank flipchart paper and markers to each
table group. Instruct participants to read each case scenario and decide as a group
what action to take. Ask the table groups to record their responses on flipchart paper
and post them when they are finished. There are questions at the end of each scenario
to aid the discussion of the small groups. Allow about 10 minutes for completion of the
activity. If time is short, the trainer may wish to assign only one or two of the four
scenarios to each group. Different assignments may be given to each group so that all
four situations are discussed when the large group reconvenes.
Reconvene the large group. Solicit input regarding each of the scenarios from the small
groups. Use the information below as a discussion guide.
1. There is a strained relationship between a father and his 15-year old daughter.
The father has set 11:00 p.m. as the curfew for his daughter. The daughter
returns home at 1:00 am, the third time in the past two weeks that she has
missed the curfew. After each incident, the emotion between father and daughter
has been escalating. This time, the father has been drinking and he is enraged.
The father chases his daughter but cannot catch her. In desperation, he picks up
a chair and hurls it at her and she ducks down so that the chair narrowly misses
her head. The legs of the chair are implanted in the drywall-constructed wall.
• Is this suspected child abuse? Yes
• If so, what type and why? If not, why? Imminent Risk of Physical abuse.
Child could have been injured by the chair being thrown at her.
• What would you do? Report to ChildLine
2. A friend complains to you about her neighbors –a man, woman, and their sixyear-old son. The friend fears that the young boy is not properly cared for. The
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man and woman yell loudly all the time and the boy appears unhappy and
unclean. She doesn’t think that he gets to school regularly, and he appears to be
out-of-control and gets on his parents’ nerves. The friend tells you about an
incident when the son was three years old. The father grabbed the boy and hung
him out of their third story apartment. He threatened to drop the boy if he did not
behave. The boy was heavy and the father nearly lost his grip on the child when
the mother grabbed the child and brought him back into the apartment.
• Is this suspected child abuse? No
• If so, what type and why? If not, why? It is not a recent act. The boy is now six
and it happened when he was three.
• What action would you take? You can report it to the county agency as
general protective services.
3. A colleague reports to you that a child in your daycare program has been
spending time alone with a known child molester. The mother has been asking
the molester to babysit on Friday nights since she cannot find another sitter. You
believe that the mother knows that the man has molested other children and has
not received treatment. You do not have any reason to believe that the child in
your program has been molested.
• If so, what type and why? If not, why? Imminent risk of sexual abuse. Mother
knows about his history and allows him to have access to child.
• Do you have any legal obligations in this matter? Yes, you are a mandated
reporter. A mandated report is “a person who, in the course of employment,
occupation or practice of a profession, comes into contact with children shall
report or cause a report to be made in accordance with section 6313 (of the
Child Protective Services Law) when a person has reasonable cause to
suspect, on the basis of medical, professional or other training and
experience, that a child under the care, supervision, guidance or training of
that person or of an agency, institution, organization or other entity with which
that person is affiliated is a victim of child abuse, including child abuse by an
individual who is not a perpetrator.”
• What would you do? Report to ChildLine.
4. A parent tries to obtain drugs through offering her daughter for sex. There are no
offers.
• If so, what type and why? If not, why? Imminent risk of sexual abuse. The
parent is offering her daughter for sex in exchange for drugs. Parent is
actively placing child in an unsafe situation.
• What action would you take? Report to ChildLine
Close the activity by stating that workers must be sure to consult with their supervisors if
they have a situation that they think may be imminent risk.
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Section VII: Non-accidental Serious Mental Injury
(60 minutes)
 Recognize the definition of serious mental injury as defined in the Child
Protective Service Law;
 Recognize the various forms of emotional abuse;
 Recognize techniques that may be used to assess the emotional abuse of a
child;
 Identify the factors that suggest emotional abuse;
 Describe the range of behaviors that are considered to be emotional abuse;
 Identify the indicators of emotional abuse;
 Define serious mental injury according to the CPSL; and,
 Recognize the link between Domestic Violence and Child Abuse.
Lecture, Large Group Discussion
Materials Needed:
 Flipchart stand
 Colored markers
 Handout #30 (Forms of Emotional Abuse)
 Handout # 31 (Assessment Techniques for Emotional Abuse)
 Overhead #17 (Non-accidental Serious Mental Injury)
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Section VII: Non-accidental Serious Mental Injury
Step 1: Defining Non-accidental Serious Mental Injury
Lecture
(20 minutes)
Trainer Note: Explain that in the CPSL, the words “serious mental injury” is used to
describe “emotional abuse.” Most counties will use the term “emotional abuse” when
talking about the abuse category “serious mental injury.”
Although other types of maltreatment, especially physical and sexual abuse, receive the
lion’s share of the public’s attention, emotional maltreatment often causes more longterm damage to children. The social problems that play into emotional abuse are similar
to the ones that underlie other forms of abuse, yet there is less societal consensus
about when to intervene. There is also very little in the way of research to help us
identify a specific family profile or treatment plan for abuse. However, we will briefly
discuss what we do know about family dynamics and major risk factors, assessment
questions and factors that might protect children from emotional harm.
Using Overhead #17 (Definition of Non-accidental Serious Mental Injury), define
Non-accidental Serious Mental Injury.
Any act or failure to act by a perpetrator that causes non-accidental serious mental
injury to a child less than 18 years of age.
Serious mental injury is a psychological condition, as diagnosed by a physician or
licensed psychologist, including the refusal of appropriate treatment, that:
• Renders a child chronically and severely anxious, agitated, depressed,
socially withdrawn, psychotic or causes reasonable fear that the child’s life
or safety is threatened; or
• Seriously interferes with a child’s ability to accomplish age-appropriate
developmental and social tasks.
Provide participants with this example or an example of your own.
• As far back as anyone can remember, Carol has regularly told Mary how lazy
and stupid she is. Everywhere they go, Carol is heard telling Mary what she is
doing wrong. Carol routinely tells Mary, as well as anyone else who will listen,
that all of Carol's problems began when Mary was born. Carol has long
complained that she could not keep a job because Mary was so demanding.
When Mary entered school, she was behind her age-mates, would not
attempt new assignments, and did not appear to enjoy any activity. At the first
parent conference, Carol told the teacher that she had always recognized that
Mary was lazy, stupid, and a troublemaker. Mary has a very short attention
span. In third grade, Mary was referred to the school psychologist for
depression. Later that year, she was found sitting on the playground in belowzero-degree temperatures without a coat, gloves, or hat. When asked what
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was wrong, she said, “Nothing....” without looking at the teacher. Although
Mary never complained to anyone, another student called the teacher's
attention to the fact that Mary's hands “looked weird.” The school nurse
referred Mary to a pediatrician. Mary had frostbite.
Explain that the Child Protective Services Law has defined “serious mental injury” that
may or may not be associated with other types of abuse. Whether the child’s behavior
indicates mental health problems or emotional trauma resulting from child abuse, they
both can cause mental injuries. They affect the child’s normal cycle of physical and
emotional growth.
Emotional maltreatment interrupts the process of attachment, affective development,
and social interaction capacities. Early detection and treatment of mental injuries and
emotional problems are critical for lessening the child’s developmental damage and
maturational impairment.
During the investigation of child maltreatment reports, the child welfare professional
may be able to assess the extent of the emotional harm to the child. However,
emotional abuse or neglect may not be reported at the intake level; its symptoms may
be discovered during the ongoing casework with the child, parent/caretaker, or in the
foster care placement. In both instances, mental health evaluation and a treatment plan
would be necessary for the child.
Emotional maltreatment is a concerted attack on a child's self concept and social
competence. It may or may not be a conscious act by the parents or other caregivers.
Regardless of the intent, the consequences to the child are the same. Its pattern, of
psychologically destructive behavior by an adult, can take the form of an act of
omission, such as ignoring the child, or an act of commission, such as repeatedly telling
the child that he or she is stupid. It is the most elusive and can be the most damaging of
the types of maltreatment.
Emotional maltreatment can take many forms. The younger the child and the less
developed the child's sense of self and identity, the more serious the physical, social,
and emotional consequences. Emotional maltreatment of older children with a wellestablished sense of self may have less impact than the same action on a younger child
or a previously maltreated child.
Emphasize that when child welfare professionals identify the possibility of emotional
trauma as a result of abuse, or that the child’s emotional and behavioral maladjustments
are indications of the mental illness, it is imperative that a physician or licensed
psychologist evaluate the child and provide treatment recommendations. These medical
and/or mental health evaluations must show that the mental injury is caused by the acts
or omissions of a perpetrator as defined by the Child Protective Service Law. Mental
health consultations and evaluations must be part of the case record documentation.
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Step 2: Form of Emotional Maltreatment
Lecture, Large group discussion
(20 minutes)
Using Handout #30 (Forms of Emotional Maltreatment), explain to the participants
that emotional maltreatment varies in intensity from occasional, to mild, to extreme, over
a sustained period of time. Some possible actions by a perpetrator that may cause a
child to have a serious mental injury are:
 Denying Emotional Responsiveness or Ignoring: This includes the caregiver
ignoring the child's attempts and needs to interact, and showing no emotion in
interactions with the child. Denying emotional responsiveness includes:
• being detached and uninvolved through either incapacity or lack of motivation;
• interacting only when necessary;
• failing to express affection, caring, and love for the child.
 Spurning (or Hostile Rejecting/Degrading) includes verbal and non-verbal
caregiver acts that reject and degrade the child. Spurning includes:
• belittling, degrading and other non-physical forms of overtly hostile or
rejecting treatment;
• shaming and/or ridiculing the child for showing normal emotion such as
affection, grief or sorrow;
• consistently singling out one child to criticize and punish, to perform most of
the household chores, or to receive fewer rewards;
• public humiliation.
 Isolating includes caregiver acts that consistently deny the child opportunities to
meet needs for interacting/communicating with peers or adults inside or outside
the home. Isolation can come from a variety of caregiver motivations, but the
resulting behavior prevents children from having opportunities for social relations
with both adults and peers. Some isolating caregivers are themselves fearful of
the outside world and want to protect the children from the dangers they believe
exist from contact with others. Isolation and domestic violence is also present in
sexually abusive families and in families where ritualistic abuse occurs. The
isolation is to keep what happens in the family a secret and to keep the children
from learning that there is any other way of life.
 Isolating includes:
• Confining the child or placing unreasonable limitations on the child's freedom
of movement within his/her environment;
• Placing unreasonable limitations or restrictions on social interactions with
peers or adults in the community.
 Terrorizing includes caregiver behavior that threatens or is likely to physically
hurt, kill, abandon, or place the child or the child's loved ones/objects in
recognizably dangerous situations. Terrorizing includes:
• placing a child in unpredictable or chaotic circumstances;
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•
•
•
•
placing a child in recognizably dangerous situations;
setting rigid or unrealistic expectations with threat of loss, harm, or danger if
they are not met;
threatening or perpetrating violence against the child;
threatening or perpetrating violence against a child's loved ones or objects.
 Exploiting or Corrupting includes caregiver acts that encourage the child to
develop inappropriate behaviors (self-destructive, anti-social, criminal, deviant, or
other adaptive behaviors). In families where parents are corrupting their children,
the parents could be repeating the parenting cycle. They pass on the type of
parenting they received, thus exhibiting the lowered parental capacities that their
caregivers exhibited. Parents, who themselves have antisocial behaviors,
commonly transmit those values, actions, and attitudes to their children. These
parental behaviors result from some events in their own lives.
Exploiting/corrupting includes:
• Modeling, permitting or encouraging antisocial behavior (e.g. prostitution,
performance in pornographic media, initiation of criminal activities, substance
abuse, violence to or corruption of others);
• Modeling, permitting, or encouraging developmentally inappropriate behavior
(e.g., parentification, infantalization, living the parent's unfulfilled dreams);
• Encouraging or coercing abandonment of developmentally appropriate
autonomy through extreme over-involvement, intrusiveness, and/or
dominance (e.g. allowing little or no opportunity or support for child's views,
feelings, and wishes; micromanaging child's life);
• Restricting or interfering with cognitive development.
 Mental health, medical, and educational neglect: This includes unwarranted
caregiver acts that ignore, refuse to allow, or fail to provide the necessary
treatment for the mental health and educational problems or needs of the child.
Mental health, medical, and educational neglect includes:
• Ignoring the need for, failing or refusing to allow or provide, treatment for
serious emotional/behavioral problems or needs of the child;
• Ignoring the need for, failing or refusing to allow or provide treatment for
services for serious educational problems or needs of the child.
•
Family violence or Domestic violence: Exposure of children to domestic violence
can be a form of emotional maltreatment. It is not uncommon for there to be
spousal abuse occurring at the same time a child is being maltreated. Within
families killings account for 25% of all homicides. Children are often times the
witness of the violence, may be injured in the course of a spousal assault, or may
become a target for victimization themselves. The impact on children can be
seen through their emotional, behavioral, and school problems. Factors such as
age, coping style, and severity of violence witnessed mediate the effects on a
given child.
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Trainer Note: ChildLine will accept reports of serious mental injury until the victim is
age 20 without regarding to the term “recent” as it is not found in the CPSL at section
6303 (b). In these cases, if there is a question as to whether or not the perpetrator
continues to have access to children potentially impacting their safety, ChildLine will
give information to the county agency as a GPS for the county agency to determine
if/how they should follow up on the case involving the other children with whom the
alleged perpetrator may have access.
Ask participants to discuss and write on flipchart how Domestic Violence is displayed
through Physical abuse, Emotional Psychological abuse, Sexual Abuse, and Economic
Abuse. Review the following indicators if not already mentioned by the groups.
1. Physical:
Biting;
Kicking;
Punching;
Stabbing;
Burns;
Strangulation;
Weapons;
Shoving; and
Throwing (something or someone).
2. Emotional Psychological:
Name-calling;
Put-downs;
Threats;
Control (of schedule);
Isolation;
Extreme jealousy;
Ridicule; and
Undermining.
3. Sexual Abuse:
(Marital) rape;
Sexual assault;
Force of multiple partners;
Audiovisual of sexual activity and sharing without consent;
Forced pregnancy; and
Threats to sexually hurt the children.
4. Economic Abuse:
Control of money;
Allowance;
No say in purchases;
Control of where / if work /go to school;
Interfering with job by calling employer; and
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Transportation (draining car battery, slashing tires).
Step 3: Identifying Emotional Maltreatment
Lecture
(10 minutes)
Distribute Handout #31 (Assessment Techniques for Emotional Maltreatment) and
explain to the participants that the child welfare professional must use a variety of
techniques and sources to identify whether a child is at risk of being emotionally
abused. These resources include:
Assessment techniques and sources of information
• The child-caregiver relationship:
Psychological maltreatment consists primarily of messages a child receives about
him/herself and about important interpersonal relationships.
The child-caregiver relationship should be observed. Because of the chronic nature
of much psychological maltreatment, repeated observations may be necessary to
obtain a representative sample of behavior and to provide grounds on which to
recognize patterns of child-caregiver interaction. Observations of the interaction
have limitations because caregivers may demonstrate appropriate parental
capacities in front of others and only display their diminished capacities when alone
with the child.
The child-caregiver relationship can also be assessed through interviews of the
caregiver and the child, review of pertinent records, observation, consultation with
other professionals, and collateral reports from siblings, grandparents, school and
daycare personnel, neighbors, and others.
Some caretaker characteristics associated with emotional maltreatment include:
• Substance abuse: Parents who abuse substances have a tendency to
ignore and neglect and are not aware of their parental responsibility;
• Interactional stress between the parent and child, resulting in power
struggles;
• Poverty;
• Parental history of psychological maltreatment;
• Parental impulsivity;
• Low self-esteem;
• Instability in the environment “Disruption, chaos and Deprivation”:
relationship between family members is unstable and the members of
families are socially and emotionally deprived;
• Social Isolation/lack of community support;
• Lack of parenting skills
Assessment of the caregiver usually includes one or more interviews, review of
collateral reports and records, and psychological testing.
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Professionals should be knowledgeable about and sensitive to cultural and ethnic
differences in caretaking styles and customs. If the evaluator is not familiar with the
cultural context of the child and family, consultation with appropriate experts is
required. Additionally, if the Child Welfare Professional does not feel competent or
sees the need for further evaluation, a referral to a mental health professional should
be made.
Step 4: Factors Protecting Children from Emotional Abuse
Lecture, Large Group Discussion
(10 minutes)
Conclude this section by informing the participants that some behavior may mitigate the
experience of emotional abuse and protect them from the harm associated with it. Ask
the participants to identify those factors - including factors related to the child, family
and community - that may serve to protect children from emotional and/or psychological
harm (mitigate the safety threats and risk) List those factors on a flipchart. Some
possible answers are:
• Positive personality dispositions;
• Parental warmth;
• Supportive school environment that reinforced child’s coping efforts;
• Positive relationship with non-offending parent;
• Other positive adult relationships;
• Child’s intelligence;
• Emotional resiliency;
• Self-efficacy and warmth;
• Cohesion with extended family;
• Child’s participation and mastery in community activities
Remind the participants when identifying nonaccidental serious mental injury they must
also consider these positive behaviors and parents’ protective capacities.
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Section VIII: Serious Physical Neglect and General Protective
Services
(1 hour 40 minutes)
 When presented with a case example, participants will correctly identify the
components of serious physical neglect.
Lecture, Small Group Activity, Large group Activity, Large Group Discussion
Materials Needed:
 Flipchart Paper
 Colored markers
 Handout #32 (Serious Physical Neglect)
 Handout #33 (Case Example of Serious Physical Neglect)
 Handout #34 (General Protective Services and Dependent Child)
 Overhead #18 (Serious Physical Neglect)
 Overhead #19 (Defining General Protective Services)
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Section VIII: Serious Physical Neglect and General Protective
Services .
Step 1: Identifying Common Ground between Child Welfare Professionals and
Families.
Large Group Activity
(20 minutes)
Ask the participants to stand-up, stretch, and form a large circle in the center of the
room. Explain to them that you will be asking a series of yes and no questions.
Whenever, their response is yes to a question, they are to step into and then out of the
circle. (They do not remain in the circle after each response.)
Trainer Note: Emphasize to the participants the need to respect each other’s
confidentiality. The trainer also should participate in the circle activity so to model
appropriate participation.
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Have you or anyone in your family been raised in a single parent household?
Have you or anyone in your family ever been homeless?
Have you or anyone in your family ever been left home alone as a child?
Have you or anyone in your family ever left a child home alone?
Have you or anyone in your family had to share a bed with a family member?
Have you or anyone in your family ever gone to bed hungry?
Have you or anyone in your family ever wore clothing that didn’t fit?
Have you or anyone in your family ever had to wear “hand me downs” or shop
at a thrift store?
Have you or anyone in your family ever been without utilities?
Have you or anyone in your family had to manage household repairs?
Have you or anyone in your family had trouble “making ends meet”?
Have you or anyone in your family had no access to health care or coverage?
Have you or anyone in your family ever missed a doctor’s appointment?
Have you or anyone in your family ever failed to return a phone call?
Have you or anyone in your family ever been exposed to domestic violence?
Have you or anyone in your family used prescription drugs not prescribed?
Have you or anyone in your family been exposed to illegal drug activity?
Have you or anyone in your family ever abused alcohol?
Have you or anyone in your family ever been incarcerated?
Have you or anyone in your family experienced a mental illness?
Have you or anyone in your family experienced a physical illness?
Have you or anyone in your family experienced loss of a loved one?
Have you or anyone in your family experienced loss of a job?
Have you or anyone in your family ever relied on welfare benefits?
Have you or anyone in your family dropped out of school?
Have you or anyone in your family ever failed a grade in school?
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•
Have you or anyone in your family been raised by a relative?
Trainer Note: The trainer may wish to edit the number of questions if time is an issue.
After the last question is asked engage the participants in a discussion regarding the
responses to the questions by asking them the following questions:
•
•
•
•
•
How many of them were uncomfortable identifying themselves or a family
member as experiencing one or more of these incidences?
How many of them associated any one of these situations as a sign of child
neglect?
If so, has their opinion changed, why?
If not, what is the difference between these occurrence and conditions that would
lead to a finding of child neglect?
Does their life experience or lack of experience in any of these areas enhance or
challenge their ability to build a rapport with parents and children and form
protective partnerships with parents in child welfare practice?
Remind the participants that in many ways we are all more like the people we serve
than we are different. Encourage the participants to recognize that the difference
between experiencing any one or more of these conditions and a finding of child neglect
can be a matter of degree, meaning how frequent or chronic is the condition and the
resulting harm or threat of harm to a child. Also remind the participants that a child
cannot be found to have been abused or neglected if a harm occurs solely from
environmental factors that are beyond the control of the parent or person responsible for
the child’s welfare, such as inadequate housing, furnishings, income, clothing and
medical care.
Step 2: Distinguishing Serious Physical Neglect and General Protective Services
(40 minutes)
Explain to the participants that Pennsylvania law and policy is unique in that the Child
Protective Services Law (CPSL) provides a definition for child neglect under both the
Child Abuse section, labeled as “Serious Physical Neglect,” and under the General
Protective Services section, labeled as “neglect.” Therefore, it is important for the child
welfare professional to distinguish between an investigation of alleged serious physical
neglect or assessment of a situation alleged to involve child neglect. An investigation of
serious physical neglect will require a “numbered” CPS report and the completion of the
CY 48.
Display Overhead #18 (Serious Physical Neglect) and explain that Pennsylvania
regulations define serious physical neglect as a:
•
physical condition caused by
o an act or failure to act of a
o perpetrator which
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•
•
endangers the child’s life or development or
impairs the child’s functioning
and is the result of:
• Prolonged or repeated lack of supervision
• Failure to provide essentials of life, including adequate medical care
Emphasize again with the participants that a child cannot be deemed to be abused if the
child’s injury is solely due to environmental factors and beyond the control of the parent
or person responsible for the child’s welfare.
Briefly review Handout #32 (Serious Physical Neglect) and explain that this prolonged
type of neglect may cause more long-term damage to children.
The definition of Serious Physical Neglect includes children who are:
• Abandoned by a parent or caregiver
o This involves leaving the child unattended with no provision for the child’s
care which results in a physical condition that endangers the child’s life or
development, or impairs functioning.
• Malnourished and dehydrated (requires a medical diagnosis)
o Failure to Thrive – a serious medical condition most often seen in young
children, where the child’s weight, height and motor development fall short
of average growth rates.
o Malnutrition – a medical condition caused from caloric deprivation and or a
vitamin deficiency
• Injured or ill and not receiving proper medical, dental or mental health treatment
o The failure to provide adequate or appropriate medical care had led to a
worsening of the child’s condition or physical harm to the child
• Living in a dangerous physical environment
o The environment must be within the parent or caregiver’s control and the
conditions are such that they have led to the child sustaining an illness or
physical injury as a result of exposure.
• Left unsupervised for a prolonged period time or are repeatedly left alone
o The parent or caregiver’s absence has the left the child without proper
care, guidance or protection, thus resulting in a physical condition that
endangers the child’s life or development and impairs his or her
functioning.
• Lacking basic physical care and hygiene
o Failure to provide basic physical care that has led to the child having
repeated infections or a persistent skin disorder that impacts upon the
child’s functioning.
• Inadequately clothed
o The child’s ill fitted or inappropriate clothing has resulted in the child being
exposed to extreme temperatures resulting in a medical condition that
impairs the child’s functioning.
If upon the investigation of a serious physical neglect allegation, the county agency
determines that a child has not been provided needed medical or surgical care because
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of seriously held religious beliefs of the child’s parent, guardian, or other responsible for
the child’s welfare, and if the beliefs are consistent with those of a bona fide religion, the
child shall not be deemed to be physically or mentally abused. The county agency shall
monitor the child closely and shall seek court-ordered medical intervention when the
lack of medical or surgical care threatens the child’s life or long-term health.
Inform the participants that in Pennsylvania twelve children died as a result of serious
physical neglect in 2009. Seven of these deaths were attributed to a lack of supervision,
three were due to medical neglect and two of the deaths were attributed to gross
negligence. (Department of Public Welfare, 2009)
Trainer Note: ChildLine will accept reports of serious physical neglect until the victim is
age 20 without regarding to the term “recent” as it is not found in the CPSL at section
6303 (b). In these cases, if there is a question as to whether or not the perpetrator
continues to have access to children potentially impacting their safety, ChildLine will
give information to the county agency as a GPS for the county agency to determine
if/how they should follow up on the case involving the other children with whom the
alleged perpetrator may have access.
Distribute Handout # 33 (Case Example of Serious Physical Neglect) and ask one of
the participants to read the following example of a case situation that rose to the level of
a finding of serious physical neglect that was reported in the 2009 Department of Public
Welfare Annual Child Abuse report.
A four-month-old female child nearly died when brought to the hospital in critical
condition. Her skin hanging from her body and she weighed only 5lbs. and 14 oz. Her
eyes and abdomen were sunken, and her skin was blue. The infant was placed on a
ventilator. She was diagnosed with failure to thrive and many other serious conditions.
She also had an existing congenital hole in her heart. The mother stated that she
noticed the child was not eating and was losing weight. She said that the child was
weak, pale and with fever. The mother stated that she did not seek treatment because
she was trying to make the child gain weight by attempting to feed her table food and
juice. The mother was named as the perpetrator as she was aware of the medical
condition of the child but failed to seek medical attention until the child was near death.
The mother had a history of substance abuse and having two older children, siblings of
the infant, removed from her care, one due to the mother giving drugs to the child to
help the child to sleep.
Referring to Overhead # 18 (Serious Physical Neglect) ask the participants in a large
group to identify the components of the serious physical neglect definition within this
case example. Possible answers include but are not limited to:
•
•
•
Physical condition:
o Failure to thrive, skin hanging from body, eyes and abdomen sunken
An act or failure to act:
o Mother (perpetrator) did not obtain medical treatment for known medical
condition.
Endangers the child’s life or development
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•
o Critical condition, nearly died,
o Significant below age in development
Failure to provide essentials of life, including adequate medical care
o Mother (perpetrator) did not obtain medical treatment for known medical
condition.
Step 3: General Protective Services
Lecture
(30 minutes)
Explain to the participants that general protective services reports are those that do not
meet the criteria for an allegation of child abuse under the Child Protective Service Law.
In Pennsylvania, child neglect is captured under the heading of General Protective
Services in the Child Protective Services Law. Reports that fall under this category are
assessed rather than investigated. It is not required to share the agency’s findings with
ChildLine, as these reports are not registered or numbered.
Display Overhead #19 (General Protective Services) and review with the participants
the definition of general protective services:
 Services to prevent the potential for harm to a child.
o Potential for harm: likely, if permitted to continue, to have a detrimental
effect on the child’s health, development or functioning.
 Services to insure the safety and well-being of a child.
 Services provided by each county for non-abuse cases.
Inform the participants that in 2009, Pennsylvania reported that ChildLine received
36,373 General Protective Services reports. However, the number of actual reports
assessed by general protective services may be much higher as these reports are not
registered or numbered and assessments and services are provided through individual
county children youth services agencies.
Distribute Handout # 34 (General Protective Services) and explain to the participants
that definition for Dependent Child, under the Juvenile Act provides a definition for those
situations that may result in the child welfare professional’s decision to provide general
protective services. Review the provisions with the participants.
General protective services—Services to prevent the potential for harm to a child who
meets one of the following conditions:
(i) Is without proper parental care or control, subsistence, education as required by
law, or other care or control necessary for his physical, mental, or emotional health, or
morals.
Page 74 of 86
Explain to the participants that it is this section that encompasses the meaning of child
neglect. Ask the participants to provide some examples of without proper parental care
or control, subsistence, education, or other care or control necessary for his physical,
mental, or emotional health or morals. Some possible answers include but are not
limited to:
•
•
•
•
•
•
•
•
•
•
Young children home alone or any children left home alone for extended periods
of time.
A child who is noticeably underweight/overweight.
A child who is sick and has not been taken to the doctor.
Deplorable housing conditions (electrical wires exposed, missing windows in
winter, no heat in winter, feces throughout the house, vermin throughout the
house).
Kids with rotten teeth, chronic lice, scabies.
Dressed in summer clothes in winter.
Do not attend school at all or not on a regular basis.
Undiagnosed and untreated developmental delays.
Undiagnosed and untreated mental illness.
Use of drugs/alcohol which interferes with children’s care.
Additional conditions that may lead to the provision of general protective services
are:
(ii) Has been placed for care or adoption in violation of law.
(iii) Has been abandoned by his parents, guardian or other custodian.
(iv) Is without a parent, guardian or legal custodian.
(v) Is habitually and without justification truant from school while subject to
compulsory school attendance.
(vi) Has committed a specific act of habitual disobedience of the reasonable and
lawful commands of his parent, guardian or other custodian and who is ungovernable
and found to be in need of care, treatment or supervision.
(vii) Is under 10 years of age and has committed a delinquent act.
(viii) Has been formerly adjudicated dependent under section 6341 of the Juvenile
Act (relating to adjudication), and is under the jurisdiction of the court, subject to its
conditions or placements and who commits an act which is defined as ungovernable in
subparagraph (vi).
(ix) Has been referred under section 6323 of the Juvenile Act (relating to informal
adjustment), and who commits an act which is defined as ungovernable in
subparagraph (vi).
Page 75 of 86
Caution the participants to recognize that families receiving general protective services
should be taken very seriously as the outcomes stemming from child neglect can prove
to be more serious than an injury sustained in a child abuse report and may lead to life
threatening situations. In 2009, of the 43 substantiated child death reports, none of the
children had been a previous victim of substantiated abuse. However, twenty-six, over
half of their families had previously received general protective services, intake services
or other services through their county agencies.
Also caution the participants that the child welfare professional’s assessment regarding
the existence of neglect can be influenced by their values and biases. Ask the
participants to identify those conditions or circumstances that might be confused for
child neglect. Some answers include but are not limited to:
•
•
•
•
Children who are dirty and generally unkempt.
Children who are starved for attention.
Children who are not doing as well in school as they could.
Children who live in marginal housing conditions.
Step 4: Behavioral and Emotional Indicators of Child Neglect
Large Group Discussion
(10 minutes)
Explain to the participants that behavioral and emotional indicators can alert the child
welfare professional to the existence of neglect in a family. Engage the participants in a
large group discussion by asking them to identify the behavior and emotional indicators
of child neglect that they may see. Record their responses on flip chart paper. List those
indicators on a flipchart. Ensure that all of the following are listed and explained.
•
Developmental delay: A very large percentage of neglected children are
developmentally delayed in some or all developmental domains. The
determination of a delay can be made by comparing the child's developmental
level with expected developmental achievements for the child's chronological
age. Neglected children may display mild to serious delays in physical/motor
development, cognitive ability, school achievement, social skills, interpersonal
relationships, and emotional development. Severely neglected children may
develop mental retardation as a result.
•
Apathetic and Unresponsive: Neglected children are often described as
unresponsive, placid, apathetic, dull, lacking in curiosity and uninterested in
their surroundings.
•
Depressed: Neglected children may not actively approach other people, nor
do they exhibit a normal degree of interest or exuberance in interpersonal
interactions. They may not play, or they may play half-heartedly. In cases of
serious neglect, the child may exhibit signs of depression.
Page 76 of 86
•
Hungry and Tired: Neglected children may appear to be hungry, or always
tired, such as falling asleep in school. Some older children who are
inadequately fed use their own resources by scrounging for, or stealing food.
•
Out of Control: Some neglected children may be "out of control" as a result of
not having the chance to learn limits of behavior from adult caregivers. They
may exhibit a variety of behavior problems, anxiety, and other signs of
emotional distress. At times, a false bravado can be seen.
•
School failure: Neglected children may experience school failure due to an
inability to concentrate, falling asleep in class, and a lack of interest in the
school environment. School failure by itself cannot be considered the result of
neglect, but can support a diagnosis of neglect when other indicators are also
present.
Summarize for the participants that child neglect can present challenges in child welfare
practice. Often times it is difficult to connect the parent’s conduct or lack of conduct with
harm or potential harm to the child. In addition, child welfare professionals must
recognize the differences in values, norms, and standards of acceptable child-rearing in
different cultural groups. A failure to understand these differences might lead the child
welfare professional to misinterpret the parents' behavior and protective capacities.
They must also take into account how poverty creates another crisis for families.
Poverty can prevent parents from meeting their children's basic needs in many ways.
Families in poverty often have inadequate shelter, at times have no food, cannot afford
medical care, and may be so overwhelmed that they have little emotional energy to
attend to their children. Yet, the parents may be providing for their children to the best of
their ability under extremely difficult circumstances. These "gray areas" may create
difficult dilemmas for the child welfare professional since the risk of harm to the child
occurs over time due to on-going and chronic depravation or exposure to a neglectful
environment and constant assessments will be needed to ensure the child’s safety.
Trainer Note: Section 6373 of CPSL (related to General Protective Services) requires
county agency’s to aid the child and family in obtaining benefits and services for which
they may qualify under Federal, state, and local programs.
Emphasize to the participants that, children youth services agencies are required to
provide preventive and supportive services to families who are unable to meet the
needs of their children because of economic and environmental limitations.
Remind the participants that when investigations, assessments and the provision of
services are delivered in a strength-based, solution-focused manner they are better able
to assure the safety, permanence and well-being of children.
Page 77 of 86
Section IX: Student Abuse
20 minutes
Performance Objectives: participants will be able to:
 Recognize the definition of student abuse as defined in the Child Protective
Service Law.
Methods of Presentation
Lecture, Small Group Activity, Large Group Discussion
Materials Needed
 Handout #35 (Student Abuse Quiz)
 Overhead #20 (Student Abuse Is…)
Page 78 of 86
Section IX: Student Abuse
Step 1: Defining Student Abuse
Lecture
(10 minutes)
Display Overhead #20 (Student Abuse Is…) and provide a description of Student
Abuse according to the Child Protective Services Law.
Student abuse is the serious bodily injury or sexual abuse or sexual exploitation to a
student by a school employee.
A student is defined as an individual who is under 18 years of age and is enrolled in a
public or private school, intermediate unit or area vocational-technical school.
School employee is defined as a person employed by a school, unless they he/she has
no direct contact with students. This includes persons employed by an independent
contractor of a school.
Emphasize to the participants that the Child Protective Service Law never refers to the
school employee as a perpetrator. They are school employees suspected of abusing a
child, or school employees responsible for abusing a child.
According to the Child Protective Service Law only two types of abuse are included in
student abuse:
• Sexual abuse/exploitation. The act would need to fit one of the eleven types of
sexual abuse that were previously discussed.
•
Serious bodily injury. This type of abuse must cause:
 substantial risk of death, or
 serious permanent disfigurement, or
 protracted (a long, drawn out or prolonged) loss or impairment of an organ or
other body part.
Ask participants how serious bodily injury is different than the definition of serious
physical injury?
Serious bodily injury: Permanent disfigurement or prolonged loss,
Serious physical injury: significantly impairs a child's functioning, either temporarily or
permanently or causes a child’s severe pain.
Clearly identify that these requirements apply whenever a school employee is
functioning in the role of a school employee regardless of when or where the abuse
occurred. They do not apply when a school employee is paid by the parents or student
Page 79 of 86
for what they are doing with the student, or if the employee is otherwise with a student
and not functioning as a school employee.
For example, a teacher who helps a student with his or her studies, or is involved in an
extracurricular activity, after school hours would be included in student abuse. However,
if the teacher was being paid by a parent to tutor a student, the teacher would be
considered a self-employed agent of the parent. In this case, the teacher could be
considered a person responsible for a child's welfare and investigated under the other
CPSL rules.
Step 2: Student Abuse Referral Process
Lecture
(10 minutes)
Explain to the participants that the referral process for student abuse is different than
other forms of child maltreatment.
Referral sources for student abuse are typically school employees, who must make a
referral to a school administrator, often the principal, when they suspect that a student is
a victim of serious bodily injury or sexual abuse/exploitation by a school employee.
Upon receipt of a report, the school administrator must immediately refer the case to the
appropriate law enforcement officials and the district attorney.
An independent investigation by the administrator is not permitted.
If the school administrator is suspect of student abuse, then the school employee
suspecting student abuse must gives the information directly to law enforcement
officials and the district attorney.
Upon receipt of a report of student abuse, the law enforcement officials will conduct an
initial review.
If the law enforcement officials suspect that evidence of serious bodily injury or sexual
abuse/exploitation by a school employee exist, then they will make a referral to the
county children and youth services agency.
The children youth services agency must register the complaint with ChildLine.
The law requires also requires that children youth service agency and law enforcement
agency coordinate their investigations. Interviews with the student must be conducted
jointly. However, law enforcement officials may exercise their right to interview the
school employee prior to the county agency has any contact with him or her.
the participants that c is the correct answer.
Page 80 of 86
Step 3: Small Group Activity, Large Group Discussion
(20 minutes)
Distribute Handout #35 (Student Abuse Quiz), a 10-part true - false quiz and ask
participants to answer the questions at their table groups. After 10 minutes, engage the
participants in a large group discussion using the information below.
1. All school employees, except the administrator, meet the definition of perpetrator
under the CPSL.
• False. School employees are not referred to as perpetrators under the CPSL.
All school employees, including administrators, can be considered school
employees responsible for student abuse. There is an exception for
individuals who have no direct contact with students.
2. Any child under the age of 18 who is enrolled in a public or private school,
intermediate unit or area vocational-technical school can be classified as a
student.
• True. This is the definition of student in the CPSL.
3. When a report of suspected student abuse is received by the county agency from
the parent, the agency should direct the parent to contact the school
administrator.
• True. However, the agency also is expected to take the information and report
it to the administrator as well. If the parents state that they have notified the
administrator and the administrator has refused to make a report, the agency
shall take the information and report it to the administrator, law enforcement
and the district attorney.
4. If the agency has a contract with a facility and a school employee of that facility is
identified as a school employee suspected of student abuse, the agency should
conduct a thorough investigation into the matter, prior to filing a report with
ChildLine.
• False. This school employee would be considered an agent of the county
agency because the agency has a contract with the facility. Therefore, this
would be investigated by a regional representative.
5. Administrators should report suspected student abuse to the county agency and
the police.
• False. Administrators are mandated to report to law enforcement and the
district attorney. They are not mandated to report to the county agency or
ChildLine.
6. A child who has multiple bruises as a result of being hit by a school employee is
likely a victim of student abuse.
• False. The child would not be considered a victim of student abuse because
his injuries do not constitute serious bodily injury.
Page 81 of 86
7. A teacher who is being paid by the parents to tutor their child would be
considered a perpetrator of child abuse, rather than a school employee
responsible for student abuse, if that teacher sexually abused the child while
tutoring the child.
• True. The school employee in this situation is the agent of the parent in the
role of tutor paid by the parent. Therefore, the school employee would be
considered a person responsible for the child’s welfare, as found in the
definition of perpetrator in the CPSL.
8. The interviews of the child shall be conducted jointly by law enforcement, CPS,
and the school administrator.
• False. The administrator is not part of the investigator process. Only CPS and
law enforcement are. The CPSL requires joint interviews of the child by CPS
and law enforcement.
9. If a school employee hits a student in the mouth and knocks out the student's
permanent teeth, it could be considered student abuse.
• True. The loss of the permanent teeth should be considered serious bodily
injury. .
10. A school bus driver is not considered a school employee.
• False. The school bus driver is a school employee under the CPSL.
Conclude this section reminding the participants of the unique criteria for identifying and
investigation Student Abuse. Remind the participants that it is important to obtain
support and advice from their supervisor if they suspect an incident of student abuse.
Page 82 of 86
Section X: Summary and Conclusion
(20 minutes)
 Review the information presented in the module.
Lecture, Individual activity
Materials Needed:
 Trainer evaluation forms
 Handout #3 Action Plan/Idea Catcher) revisited
 Handout # 36 (Bibliography)
 Trainer Evaluation Form
Page 83 of 86
Section X: Summary and Conclusion
Trainer Note: Review the WIIFM poster and be sure that all of the questions and
concerns have been addressed.
Step 1:
Lecture
(5 minutes)
Ask the participants whether they have any additional thoughts or questions. Address
those questions/comments that you can and place on the Parking Lot those thoughts or
questions that you cannot address. Assure participants that you will follow up on those
comments/questions that participants brought up during the module.
Remind the participants that this module has been an introduction to identifying child
abuse and neglect designed to provide them a foundation for the law and beginning
skills in identifying the various types of abuse. Remind them that advance courses are
available on child sexual abuse and investigation and assessment after they have
completed the entire Charting the Course towards Permanency for Pennsylvania’s
Children. Also remind the participants that they should always seek the support of their
supervisor or more experienced colleagues to obtain assistance in providing effective
services.
Step 2: Action Plan
Lecture
(5 minutes)
Ask participants to locate Handout #3 (Idea Catcher/Action Plan) and review the
action steps that they identified on their idea catcher/action plans throughout the
module. Ask participants to share their ideas concerning what they learned and how
they plan to use the information. Tell participants that part of the purpose of this
information sharing is to network and consider whether the action plans that other wrote
might benefit them.
Step 3:
Lecture
(2minutes)
Distribute Handout #36 (Bibliography) and inform the participants that references for
the material presented in this module is identified. Encourage the Participants to expand
their knowledge and improve their skills by obtaining and reading professional journals
and current research in child welfare practice.
Step 4:
(Lecture)
(3 minutes)
Page 84 of 86
Remind the participants that at conclusion of this module they will need to complete the
on-line transfer of learning assignment for the conclusion of this Module, as well as in
preparation of Module 3: Using Interactional Helping Skills to Achieve Lasting Change.
Also, remind the participants that they must complete these transfer of learning activities
to obtain certification.
Step 5:
Remind the participants to complete their post transfer of learning activity for Module 2
and to complete the pre- TOL for Module 3. If needed, ask one of the participants to
take the cohort training room guidelines with them and return it to module 3.
Step 6: Module Evaluation
Activity
(5 minutes)
Distribute the course evaluation asking the participants to complete it. Encourage the
participants to include written comments in addition to the feedback scores. Tell them
that the comments are usually the most useful information for us in improving the
curriculum and presentation.
Page 85 of 86
References
Action for Child Protection, Charlotte, NC, 2010, Key Concepts, Available from:
http://www.actionchildprotection.org/safety_intervention/key_concepts.php.
Centers for Disease Control and Prevention. Atlanta: CDC, 2006. Adverse Childhood
Experiences Study Available from: http://www.cdc.gov/nccdphp/ace/index.htm.
Commonwealth of Pennsylvania. Administration of County Children and Youth Social
Services Programs. (55 Pa. Code Chapter 3490).
Commonwealth of Pennsylvania. The Child Protective Services Law (23. Pa. C.S.
Chapter 63).
Commonwealth of Pennsylvania. The Juvenile Act (42 Pa.C.S. Chapter 63).
Department of Public Welfare, 2009, Annual Child Abuse Report
National Children’s Alliance (www.nationalchildrensalliance.org)
Pennsylvania. Pennsylvania Criminal Code: 18 PA. Consolidated Statutes Annotated
(18 PA. CSA). PA.
Pennsylvania Department of Public Welfare. Child abuse annual report 2007.
Steele, B. F.. M. E. Helfer, R. S. Kempe, & R. D. Krugman (Eds.), Psychodynamic and
biological factors in child maltreatment: The battered child (5th ed.). Chicago, IL:
The University of Chicago Press.
University of South Carolina: The Center for Child and Family Studies. (2000). Child and
adolescent development resource book. Columbia, SC: University of South
Carolina.
U.S. Department of Health and Human Services. Child Maltreatment Report. (2007)
Page 86 of 86

CHARTING THE COURSE TOWARDS PERMANENCY FOR CHILDREN IN PENNSYLVANIA:

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