MALTREATMENTS

1. MAL_PPT_070107 MALTREATMENTS HOW TO USE THE PPT TEMPLATE: To insert the course code and date, choose View/Master/Slide Master from the menu bar. Change ONLY the course code and date in the master. (Whatever is put on the master slide is copied automatically to EVERY slide.) To create individual slides, return to the View/Slide mode. Three initial slides are provided, a course title slide, a module title slide and a bulleted text slide. Copy and modify these as needed, or choose Insert/New Slide from the menu bar. You can type text directly into new slides, or you can copy text from other documents into a slide. To apply the slide design, do not use the typical “paste” command. Instead, choose Edit/Paste Special/Unformatted Text when pasting. This will strip any formatting applied in the other document and allow the slide design formatting to be used. Slides are to be numbered in sequence automatically using a code in the master slide. You should not need to insert any OH numbers. HOW TO USE THE PPT TEMPLATE: To insert the course code and date, choose View/Master/Slide Master from the menu bar. Change ONLY the course code and date in the master. (Whatever is put on the master slide is copied automatically to EVERY slide.) To create individual slides, return to the View/Slide mode. Three initial slides are provided, a course title slide, a module title slide and a bulleted text slide. Copy and modify these as needed, or choose Insert/New Slide from the menu bar. You can type text directly into new slides, or you can copy text from other documents into a slide. To apply the slide design, do not use the typical “paste” command. Instead, choose Edit/Paste Special/Unformatted Text when pasting. This will strip any formatting applied in the other document and allow the slide design formatting to be used. Slides are to be numbered in sequence automatically using a code in the master slide. You should not need to insert any OH numbers.

2. MAL_PPT_070107 OH 1 Module One: The Hotline and the Allegation Matrix

3. MAL_PPT_070107 OH 2 Abuse Hotline and Reporting Requirements What are the criteria for accepting an intake of child maltreatment? Besides child maltreatment, what other kinds of intakes are received by the Florida Abuse Hotline? Name some occupations that you think might be required by Florida Statute to provide their names when reporting abuse/neglect. What are the responsibilities of the Hotline and the District? The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

4. MAL_PPT_070107 OH 3 Abuse Hotline and Reporting Requirements During an open investigation or during supervision, when is a call to the Hotline required? When is an investigator/counselor not required to call the Hotline? How do Hotline counselors decide which calls meet the criteria for acceptance of an intake? The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

5. MAL_PPT_0701078REV OH 04 Abuse Hotline and Reporting Requirements F.S.39.201 (7) requires the review of calls and reports to the Hotline involving 3 or more unaccepted reports on a single child. To detect such things as harassment and situations warranting an investigation because of the frequency or variety of the course of the calls/reports.

6. MAL_PPT_0701078REV OH 05 Florida Abuse Hotline Receives all incoming intakes/referrals, 24 hours a day, 7 days a week (phone, TDD, Mail, Email and Fax) Seeks as much information as possible about the alleged maltreatment Gathers data regarding the subjects of the intake Uses allegation matrix to determine whether or not the allegation constitutes maltreatment Determines priority level of the investigation

7. MAL_PPT_070107 OH 6 Abuse Hotline (continued) Notifies district of intakes Checks for priors, current intakes and pervious service referrals Completes criminal background checks on named subjects Checks to determine family’s involvement with other DCF programs

8. MAL_PPT_070107 OH 7 Penalties Related to Reporting Person who knowingly or willing fails to report or prevents another person from reporting – first degree misdemeanor. Failure to report abuse (known or suspected) while residing in the same household as the victim is a third degree felony. Any person, age 18 or older, who knowingly and willfully fails to report the abuse or neglect, can be charged. An exception is in the case of a domestic violence situation or other mitigating circumstances39.205(2).

9. MAL_PPT_070107 OH 8 Mandatory Referrals to CPT injuries to the head, bruises to the neck or head, burns, or fractures in a child of any age bruises anywhere on a child five years or under any report alleging sexual abuse of a child sexually transmitted disease in a prepubescent child reported malnutrition of a child and failure of a child to thrive reported medical neglect of a child

10. MAL_PPT_070107 OH 9 Mandatory Referrals to CPT any family in which one or more children have been pronounced dead on arrival at a hospital or other health-care facility, have been injured and later died as a result of suspected abuse, abandonment, or neglect, when any sibling or other child remains in the home symptoms of serious emotional problems in a child when emotional or other abuse, abandonment, or neglect is suspected

11. MAL_PPT_070107 OH 10 F.S. 39.303(1)(a)-(j) CPT services include: medical diagnosis and evaluation services telephone consultation services (emergencies and other situations) case staffings, case service coordination and assistance psychological and psychiatric diagnosis and evaluation expert medical, psychological and related professional testimony

12. MAL_PPT_070107 OH 11 CPT Services training services educational and community awareness family psychosocial interviews specialized clinical interviews forensic interviews The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

13. MAL_PPT_070107 OH 12 When are face to face medicals NOT required? When a child had been examined by another physician or other medical professional and a consult with the CPT medical director concludes that a further medical evaluation is not necessary. The investigator, with supervisory approval, has determined after conducting a safety assessment, that there are no indications of injuries as described in 39.303(2)(a)-(h). The CPT medical director determined that a medical evaluation is not necessary.

14. MAL_PPT_070107 OH 13 Four Most Crucial Steps in the Investigative Process Step 1: Assessing the nature and severity of a reported injury or harm to a child. Step 2: Assessing the substantial likelihood of immediate injury or harm to a child. Step 3: Assessing the probability of further harm. Step 4: Determining what the finding of child abuse, neglect, or abandonment should be based on the evidence. The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

15. MAL_PPT_070107 OH 14 Allegation Matrix A description of the specific maltreatment Guidelines for evidence and documentation needed to determine the finding Contacts to make Factors to consider in determining whether or not abuse or neglect occurred An injury with no evidence to support that it was caused by abuse or neglect must have a finding of “no indicators.” The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

16. MAL_PPT_070107 OH 15 Module Two: The Dynamics of Child Maltreatment

17. MAL_PPT_070107 OH 16 Dynamics What is a dynamic? List some examples of dynamics that may be present in families who may abuse or neglect their children?

18. MAL_PPT_070107 OH 17 Maltreatment Statistics Victimization rates (per 1,000 child victims) by Maltreatment Type, 2000 - 2004 7.3% - neglect 2.3% - physical abuse 1.2% - sexual abuse .3% - medical neglect .09% - emotional maltreatment 3.2% - other types of abuse  (DHHS, 2006) The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

19. MAL_PPT_Rev_020408 OH 18 Child Fatalities 45% had prior child protection involvement 68% died as a result of neglect 32% died of physical abuse Perpetrator caregiver statistics: 52% were under the age of 29 54% were previous perpetrators of abuse/neglect 46% had history of substance abuse 69% had criminal history The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

20. MAL_PPT_070107 OH 19 What is an indicator? How would you define an indicator as it applies to child abuse and neglect? Are indicators always obvious? If not, what kinds of indicators are more subtle?

21. MAL_PPT_070107 OH 20 Relationship of child abuse/neglect indicators to the decision-making process Probe further into situations when indicators are present to thoroughly assess the immediate and long-term risk to each child. Indicators may help identify needs that are not being met. A thorough investigation or assessment assists the investigator/counselor in determining the appropriate disposition decision and services needed. Weigh indicators against identified risk factors and protective factors when making decisions about child safety. An indicator helps the investigator/counselor look at possible root causes for the abuse and neglect. A finding of “some indication” means credible evidence was gathered to support that the injury was caused by abuse or neglect and by a caregiver.

22. MAL_PPT_070107 OH 21 Making Decisions Decisions are made using a model that is applicable to all program areas The assessment of information gathered, along with all other information received, helps determine the actions to ensure continued child safety and evaluate the progress towards permanency. The decision making model is applied continuously in the case flow process

23. MAL_PPT_070107 OH 22 Module Three: Physical Abuse

24. MAL_PPT_070107 OH 23 Examples of Critical Indicators Injuries and Evidence Numerous alleged “accidental” injuries Escalating injuries Injuries inconsistent with explanation Frequent change of hospitals or physician Professional medical opinion contrary to facts

25. MAL_PPT_070107 OH 24 Examples (continued) Child Vulnerability 5 years and younger Prior intakes Limited access to or contact with child by outside world

26. MAL_PPT_070107 OH 25 Examples (continued) Target Child No observable signs of bonding with target child Flat or depressed affect Lack of peer relationships Subjected to unusual forms of discipline Only discipline used is physical Exhibits behaviors indicative of abuse or neglect Secretive about injuries

27. MAL_PPT_070107 OH 26 Examples (continued) Parent/Caretaker Characteristics Overly charming, extremely cooperative Appears to make extreme progress Tells you what you want to hear Violent and aggressive behavior Unrealistic expectations of child Alienated from family; no family support network Isolation, lack of social contacts

28. MAL_PPT_070107 OH 27 Examples (continued) Parent/Caretaker History History of abuse and neglect as a child History of alcohol or other substance abuse History of mental illness History of frequent moves History of job instability Criminal history

29. MAL_PPT_070107 OH 28 Examples (continued) Parent/Caretaker Relationship Boyfriends drifting in and out of home Relationship takes precedence over child’s needs Imbalance of power Domestic violence No clear identification of roles Open hostility and/or negative perceptions

30. MAL_PPT_Rev_020408 OH 29 Examples (continued) Physical Environment Environment poses safety risks Unsecured swimming pools/bodies of water Sleeping area for child is inappropriate Child is removed from others during common activities Home is physically isolated

31. MAL_PPT_070107 OH 30 Adult Behaviors call a child offensive names or chronically ridicule them perform willfully malicious or violent acts directed toward a child’s possessions, pets, or environment use crude, brutal, or severely misguided actions in the attempt to gain submission or enforce maximum control to modify a child’s behavior have unrealistic expectations which are inappropriate to the child’s developmental level have a need to always be in charge; always critical totally reject a child or have obvious preference for one child over another

32. MAL_PPT_070107 OH 31 Adult Behaviors (continued) have distant, shallow, or superficial relationships with family members, or are isolated from society are extremely disappointed regarding their baby’s gender fail to bond with infant suffer from acute tension, encounter chronic crises, or are easily frustrated have poor impulse control often blame the child for problems provide inaccurate, illogical, or conflicting explanations for a child’s injury

33. MAL_PPT_070107 OH 32 Adult Behaviors (continued) expose a child to repeated violent, brutal, or intimidating acts or statements leave a child in a hostile or dangerous situation fail to protect a child from inflicted injury abuse substance to the degree that they are unable to provide adequate care beat or corporally punish a child so that it leaves or it is likely to leave an injury kick, scratch, or punch a child

34. MAL_PPT_070107 OH 33 Adult Behaviors (continued) hit or slap an infant pull a child’s hair over medicate or poison a child tie a child’s limbs together or to an object

35. MAL_PPT_070107 OH 34 Variables Affecting Child’s Response to Abuse Age of the child Length of time the child has been abused Frequency of the abuse Nature of the child’s relationship with the abuser Type of abuse Availability to the child of support Constitutional factors

36. MAL_PPT_070107 OH 35 Emotional Indicators Developmental delay and abnormal developmental patterns Remote, withdrawn No expectation they will be comforted “Frozen watchfulness” Fear of physical contact Appear to be autistic Clinging dependency Depressed, lack of emotion Preschool children: easily frightened; eager to please; role reversal Adolescents: lying; stealing; use of alcohol/drugs; truancy; running away

37. MAL_PPT_070107 OH 36 Critical Indicators of Physical Abuse Frequent injuries. Multiple bruises and injuries. Bruises and injuries in inaccessible places. Injuries in different stages of healing. Injuries inconsistent with adult explanation. The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

38. MAL_PPT_070107 OH 37 Investigative Techniques Always investigate, even if the explanation seems plausible. Check other areas of the child’s body, not just the area of the injury. Interview all subjects of the intake individually. Check for and analyze all prior case histories and intakes. Refer the child to CPT. Notify Law Enforcement/SAO within mandated timeframes. Interview all persons in the environment who may have information.

39. MAL_PPT_070107 OH 38 Investigative Techniques (continued) Make plans to obtain information from school personnel and family physicians. Get the child’s version of what happened. Always probe deeper with each piece of information you gather. Each answer you receive is only a piece of the puzzle and should spark another question or clue to investigate. Always ask to see the physical source of the injury: iron, stove, burner, rope, etc. Visit the site of the “accident.” Do the physical environment and explanation for how the injury occurred match? Visit and observe the entire home environment for clues, especially the child’s bedroom. Take photographs

40. MAL_PPT_070107 OH 39 Shaken Baby Syndrome Shaken Baby Syndrome is a serious brain injury that occurs when a frustrated caregiver violently “shakes” an infant, usually to stop him/her from crying. It is considered a serious form of child abuse. Shaking a baby can cause serious injuries or death. There are usually no outward physical signs.

41. MAL_PPT_070107 OH 40 Module Four: Sexual Abuse

42. MAL_PPT_070107 OH 41 Sexual Abuse Statistics One out of every four women was sexually molested by an adult before she was 18. For men, one out of ten. Only one out of every ten cases of child sexual abuse is reported to law enforcement. For victims under age 12, the sexual offender was a family member in 47% of incidents, an acquaintance in 49%, and a stranger in just 4%. Child molesters are predominantly men. The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

43. MAL_PPT_070107 OH 42 Phases of Child Sexual Abuse Phase 1: Engagement Phase 2: Sexual Interaction Phase 3: Secrecy Phase 4: Disclosure Phase 5: Suppression The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

44. MAL_PPT_070107 OH 43 Types of Disclosure Accidental disclosure happens when the victim reveals by chance rather than deliberately. Purposeful disclosure happens when the victim makes a conscious decision to tell an outsider. The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

45. MAL_PPT_070107 OH 44 Module Five: Mental Injury

46. MAL_PPT_070107 OH 45

47. MAL_PPT_070107 OH 46 Types of Mental Injury Spurning (hostile rejecting/degrading) Terrorizing Exploiting/corrupting Isolating Denying emotional responsiveness (ignoring) Mental health, medical and educational neglect The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

48. MAL_PPT_070107 OH 47 Module Six: Substance Abuse

49. MAL_PPT_070107 OH 48 Module Six Objectives, continued

50. MAL_PPT_070107 OH 49 Substance Abuse Statistics Approximately 18 million persons abuse or are addicted to alcohol. 11 million persons abuse tranquilizers and other psychotropic drugs. 5.5 million get high on marijuana more than once a week. At least 2 million are addicted to cocaine or crack. Up to 1 million individuals use heroin. The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

51. MAL_PPT_070107 OH 50 Definitions Substance: Any chemical that modifies the function of living tissues, resulting in physiological or behavioral change. The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

52. MAL_PPT_070107 OH 51 Addiction A disease entity with its own psychopathology characterized by compulsion, loss of control, and continued use in spite of adverse consequences. Addiction is progressive, potentially fatal if untreated, and incurable but remissible through abstinence and recovery.

53. MAL_PPT_070107 OH 52 Characteristics of a Disease Primary — the disease is not a secondary symptom of something else. Progressive — the disease worsens progressively. The victim becomes physically, spiritually, emotionally, and psychologically ill. Chronic — there is no cure. Recovery from the disease must be based on abstinence from mood altering chemicals. Fatal — the disease can only be arrested. If it is not arrested, the person will die from it.

54. MAL_PPT_070107 OH 53 Elements of Disease cause effect symptoms course of action predictable outcome

55. MAL_PPT_070107 OH 54 Symptoms Associated with Stages First, people drink for relief. Second, social problems such as job loss or family problems become identified. In late stages, there is physical deterioration. Death usually occurs in 15 to 20 years. Recovery rates are 60 to 70 percent if treated in the middle stage.

56. MAL_PPT_070107 OH 55 Stages of Substance Abuse Stage 1: Experimentation and social use Stage 2: Seeking the mood swing Stage 3: Harmful abuse Stage 4: Dependency addiction The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

57. MAL_PPT_070107 OH 56 Substance Abuse: A risk factor is… an attitude, belief, behavior, situation, and/or action that may put an individual, group, organization, or community at risk for experiencing drug use and its effects. The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

58. MAL_PPT_070107 OH 57 Categories of Risk Factors Family Community/school Individual/peer/psychosocial

59. MAL_PPT_070107 OH 58 Family Risk Factors Family Management Practices The way parents manage the family may increase the possibility of alcohol and drug abuse by the children. Family History of Alcohol and Drug Abuse If a parent has a history of alcoholism or other drug abuse, the children have an increased risk of becoming substance abusers. Condoning Alcohol and Other Drug Abuse The message that alcohol and drug abuse is acceptable increases the likelihood that substance abuse will occur. Parents who drink, smoke, and abuse other substances, set an example for the children. The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

60. MAL_PPT_070107 OH 59 Family Bonding Strong relationship between parents and children Children feel safe, loved, and supported

61. MAL_PPT_070107 OH 60 Protective Factors in Parents Consistent praise/low criticism Clear expectations/high expectations Stress management Quality time/sharing responsibilities Supportive adult relationships/extended family The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

62. MAL_PPT_070107 OH 61 Protective Factors in Children Relationship with a caring, adult role model Opportunities to contribute or be a resource Success in work, play, and relationships Self-esteem Self-discipline Problem-solving skills Sense of humor Healthy expectations and positive outlook The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

63. MAL_PPT_070107 OH 62 Module Seven: Neglect

64. MAL_PPT_070107 OH 63 Module Seven Objectives, continued

65. MAL_PPT_070107 OH 64 Child Neglect What are some examples of neglect? With an allegation of neglect, what are some concerns for child safety?

66. MAL_PPT_0701078REV OH 065 Chapter 39.01(44)(a)-(b) States that neglect occurs when a child: is deprived of, or is allowed to be deprived of necessary food, clothing, shelter, or medical treatment, or when a child is permitted to live in an environment when such deprivation or environment causes the child’s physical, mental, or emotional health to be significantly impaired or to be in danger of being significantly impaired. “Neglect of a child includes acts or omissions.” The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

67. MAL_PPT_070107 OH 66 The foregoing circumstances shall not be considered neglect: If caused primarily by financial inability unless actual services for relief have been offered to and rejected by such person. A parent or legal guardian legitimately practicing his religious beliefs in accordance with a recognized church or religious organization who thereby does not provide specific medical treatment for a child shall not, for that reason alone, be considered a negligent parent or legal custodian.

68. MAL_PPT_070107 OH 67 The Court Can… Order the following services to be provided, when the health of the child so requires: “Medical services from a licensed physician, dentist, optometrist, podiatrist, or other qualified health care provider”; or “Treatment by a duly accredited practitioner who relies solely on spiritual means for healing in accordance with the tenets and practices of a well-organized church or religious organization.”

69. MAL_PPT_070107 OH 68 The Types of NeglectRecognized by the Allegation Matrix 37N – Bizarre Punishment (Institutions) 39N – Mental Injury 41N – Substance Misuse 50N – Inadequate Supervision 53N - Abandonment 55N – Environmental Hazards 60N – Malnutrition/Dehydration 61N – Failure to Thrive 65N – Medical Neglect 97N – Failure to Protect 99N – Death due to Neglect

70. MAL_PPT_070107 OH 69 The IndicatorsAre Classified into Four Categories Physical indicators Environmental indicators Child’s behavioral indicators Caregiver’s behavioral indicators

71. MAL_PPT_070107 OH 70 Chronic Neglect Chronically neglectful caregivers often suffer from pervasive and profound character problems which result from their own severely emotionally impoverished childhood. Chronically neglectful families are often caught in a “cycle” of neglect. The caregivers were neglected as children and, in turn, lack the emotional capability and basic parenting skills to provide a nourishing environment for their own children. Additionally, chronically neglectful families usually share some or all of these characteristics: large families with many children and limited financial support socially isolated very little extended family support or network of friends in the community

72. MAL_PPT_070107 OH 71 Factors Many factors influence the severity of damage to a child: child’s age length of time of neglect frequency child’s relationship with caretaker availability of support personality of the child The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

73. MAL_PPT_070107 OH 72 A Child Suffers from Failure to Thrive when… weight for height is below the 5th percentile of the population on a standard weight/height curve (some experts recommend 3rd percentile). actual weight is 20% or more below the ideal weight for height. weight gain is significantly slower than normal. triceps skin-fold thickness (a measurement of the total body fat) is below the 15th percentile for the population. (Schmitt and Mauro, 1989)

74. MAL_PPT_070107 OH 73 Intervention Early intervention is essential. Collaborate with medical personnel. If child remains in the home, intensive support of the family is necessary in addition to continuous monitoring of the infant on a daily basis if necessary. The decision to leave an infant in the home (or not) is based on the following criteria: the severity of the infant’s condition the caregiver’s openness to intervention the establishment of a safety plan that includes the involvement of a relative, neighbor, or friend who can assist the caregiver in caring for the infant

75. MAL_PPT_070107 OH 74 Module Eight, Part I: Domestic Violence

76. MAL_PPT_070107 OH 75 FS 39.902(1) Domestic violence is “any assault, battery, sexual assault, sexual battery, or any criminal offense resulting in physical injury or death of one family or household member by another who is or was residing in the same single dwelling unit.” The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

77. MAL_PPT_070107 OH 76 Domestic violence is… “a pattern of assaultive and coercive behaviors, including physical, sexual, and psychological attacks, as well as economic coercion, that adults or adolescents use against their intimate partner.” (Ganley & Schechter, 1995) The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

78. MAL_PPT_070107 OH 77 Physical Abuse The most obvious form of domestic violence is physical abuse. Batterers are aware that visible physical evidence could draw the wrong kind of attention, so they selectively hit the victim in areas that will not be so readily seen. Batterers might: pull the victim’s hair bang the victim’s head against the wall shake the victim violently Serious internal or neurological injury might occur.

79. MAL_PPT_070107 OH 78 Emotional/Psychological Abuse This type of abuse does not directly kill the victim but can be the driving force behind physical abuse or the victim’s belief that she might be physically harmed. The batterer may make covert threats. The batterer may intimidate the victim by threatening to take the children because she is an “unfit mother”. Driving forces behind emotional abuse: The victim believes that what the batterer says is true. The victim believes that the batterer can do all that he threatens. Enduring emotional abuse and the isolation that comes with it is worse than enduring physical abuse.

80. MAL_PPT_070107 OH 79 Sexual Abuse Any attempt to force a partner to act against his or her will (Marital rape is punishable by law in Florida). Sexual battering consists of a wide range of behaviors including: pressured sex when the victim does not want sex coerced sex through manipulation or threats violent sex Victims may be forced to perform acts they do not like: sex with third parties painful sex acts which are offensive to them

81. MAL_PPT_070107 OH 80 Sexual Abuse (continued) Victims may be forced to have sex at inappropriate times: when they don’t want it in front of the children when they’re asleep Victims may comply to avoid punishment or may be punished for resisting. Sexual abuse is profound and may be difficult for the victim to discuss. Some victims are unsure that the sexual abuse is really abuse, and, for others, it is the ultimate betrayal.

82. MAL_PPT_070107 OH 81 Economic Coercion Batterers attempt to control the adult victim by controlling the family finances. This limits the victim’s access to other resources such as: food shelter clothes transportation other necessities of life The batterer may expect the victim to keep all records and handle all transactions while granting limited permission to pay bills. Batterers will often hide all financial information from the victim. Adapted from Schechter and Ganley, 1995.

83. MAL_PPT_070107 OH 82 Use of Children to Control Adult Victim using the children to spy on the victim forcing the children to assault the victim making children watch the degradation/abuse of victim using the children as pawns physically assaulting or threatening to assault children in order to control the victim

84. MAL_PPT_070107 OH 83 Child Abuse Related to Domestic Violence Striking a child who tries to intervene. Forcing a child to witness or participate in beatings. Threatening to beat a child who discloses. Hitting the child with objects intended to strike the adult victim. The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

85. MAL_PPT_070107 OH 84 Children and Domestic Violence Children experience terror from witnessing family violence that changes them for life. Domestic violence can be a factor in some child abuse deaths. Preliminary research and data indicates that some child abuse begins with the battering of a spouse then escalates to include the children. The overlap between households with both domestic violence and child abuse ranges from 40 to 60 percent[1]. The risk of child abuse is 1500% greater in homes where there is domestic violence[2]. When there is an “indication” of domestic violence there are concerns of possible child abuse or neglect. [1] A Nation’s Shame: Fatal Child Abuse and Neglect in the United States, p. 12. [2] National Woman Abuse Prevention Project, Domestic Violence Fact Sheet, n.d.

86. MAL_PPT_070107 OH 85 Module Eight, Part II: Safety Planning

87. MAL_PPT_070107 OH 86 Safety planning is… …the act of finding ways to protect the child from immediate harm when the child’s safety is threatened. Examples are: The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

88. MAL_PPT_070107 OH 87 Domestic Violence and Safety Planning For the child For the adult victim For the worker The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

89. MAL_PPT_070107 OH 88 Worker Safety Important points to remember about worker safety: The incidence of violence increases going into a domestic violence situation. When batterers perceive their control is threatened by counselors’ interventions, they are likely to lash out. Exercise caution when leaving a home or the office. Notify co-workers when a potentially dangerous person is coming to the office. Contact law enforcement if the batterer has a criminal record involving violent offenses.

90. MAL_PPT_070107 OH 89 Essential Elements of a Safety Plan Plan for safety when the batterer is still in the home. Plan for safety when the adult victim or children must leave the home. Plan for safety after leaving. The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.The module number and title appear in a box at the bottom of each slide. You will need to copy this text box to each slide. Modify the number and module title as needed.

91. MAL_PPT_070107 OH 90 Safety Planning with Children Include written and verbal instructions for the children (when age-appropriate). If the child does not know how to carry out the tasks listed on the handout, talk them through it and ask the mother for help unless this will jeopardize the child’s safety. Reassure the children that they are not responsible for the domestic violence or for what happens after the domestic violence is disclosed. Children need to know that it is important for them to be safe when their mother is assaulted, and that they should not intervene during an assault. If they blame themselves for the violence or for not protecting their mother, reassure them that these are common reactions, but the violence is not their fault. Keep things simple and have the children practice and explain what they are to do.

92. MAL_PPT_070107 OH 91 Safety Planning If the child is in imminent danger: arrange for immediate removal of the child or the offending adult, or arrange some other type of protective intervention A thorough initial assessment is directly related to effective safety planning. A continual, ongoing assessment of the situation is necessary to ensure child safety, no matter where the child is in the home or in out-of-home care. Periodic reassessment and updates of the safety plan must be documented in the chronological notes. Reassessments should answer the following questions: Is the safety plan appropriate to the current circumstance? If a safety plan is not in place, does the current situation require one?