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    Objectives
    • Describe the the importance of relationships in preventing child abuse and neglect.
    • Define institutional child abuse and neglect.
    • Explain the importance of protective factors in preventing child abuse and neglect in programs.

    Learn

    Learn

    Know

    Think back to your childhood. Can you think of a time when you felt completely safe? Hold an image of the place or the experience in your mind. What do you see? What do you hear? What do you smell? What sensations do you feel? What emotions does it evoke? Who is there with you? What do they do to make you feel safe?

    For some of us, this might be an easy exercise. Some childhoods were full of safe and happy memories from which to choose. For others of us, though, this exercise is challenging. There might be few times when we experienced a feeling of complete safety, and those times might be shaded by memories of other, uncomfortable or scary experiences or events. All of us, regardless of our backgrounds, likely feel a sense of gratitude toward those people and places who helped us feel safe.

    There is a growing body of evidence that these moments, these relationships, these safe places where we feel loved and protected can make all the difference in our lives. Consider Sara’s story:

    Sara’s Story

    Sara is an amazing mom. She is incredibly bright, very reflective, and successful in her career. She is caring, loving, nurturing, responsive, and has a phenomenal relationship with her husband and children. She is the model of personal and professional success.

    Sara had a traumatic childhood. Her mother was severely mentally ill, sometimes abusive, sometimes neglectful, sometimes not present, and often suicidal. Her father was violent toward her mother. They lived in extreme poverty. When asked how she has been able to do so well given her overwhelming history of trauma, her answer was “No matter what I went through and no matter how awful it was sometimes, I know and felt how much my parents loved me. I knew that no matter how difficult life was for them, they wanted the best for me. They loved me as best they could, and they would do anything for me.”

    Sara’s story reminds us of several important ideas. First, all parents love their children very much and are doing the best they can. This is important to remember when we begin working with families. Second, the parent-child bond is strong even in the most difficult relationships — children love their parents. Third, history is not destiny: children who were mistreated do not all grow up to abuse their own children. Fourth, unconditional love makes a big difference in a child’s life. It is easy to imagine that Sara probably also had many other people rooting for her and helping her succeed. Love from a parent is critical, but extended family, neighbors, teachers, social workers, and counselors can all contribute the safe, stable, and nurturing relationships.

    Clearly, relationships are the first and most important foundation in a child’s life. Sara had a relationship with her parents, but it is also likely that she had strong relationships with other adults around her: teachers, coaches, or neighbors. These relationships helped Sara bounce back from the challenges she encountered. You have an important opportunity to build secure relationships with the infants, toddlers, and two-year-olds in your care. These relationships help children look to you for protection and care. Children come to know that adults care about them and can meet their needs. Relationships also help you understand each child deeply and help you act in each child’s best interests. This includes taking important steps to prevent child abuse and neglect in your program.

    As you remember from the course on Child Abuse Identification and Reporting, child abuse and neglect can be institutional as well as familial. This means child abuse and neglect can happen in your program. This lesson will review the concept of institutional abuse and neglect. The remaining lessons in this course will help you learn specific strategies for preventing child abuse and neglect in your program.

    You have already completed a course on identifying and reporting child abuse and neglect, and you will continue to have regular professional development on this topic throughout your career. Let’s just take a few moments to review the major definitions of child abuse and neglect.

    What is Child Abuse and Neglect?

    Federal law defines child abuse and neglect as:

    Any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse, or exploitation, or an act or failure to act which presents an imminent risk of serious harm.

    Source: Child Abuse Prevention and Treatment Act (CAPTA) Reauthorization Act of 2010 (P.L. 111-320), § 3.

    The Department of Defense (DoDD 6400.1, 2004) defines child abuse and neglect as follows:

    Child abuse and neglect includes physical injury, sexual maltreatment, emotional maltreatment, deprivation of necessities or combinations for a child by an individual responsible for the child's welfare under circumstances indicating that the child's welfare is harmed or threatened. The term encompasses both acts and omissions on the part of a responsible person. A child is a person under 18 years of age for whom a parent, guardian, foster parent, caretaker, employee of a residential facility or any staff person providing out-of-home care is legally responsible. The term child means a natural child, adopted child, stepchild, foster child or ward. The term also includes an individual of any age who is incapable for self-support because of a mental or physical incapacity and for whom treatment in a medical treatment facility is authorized.

    According to the U.S. Department of Health and Human Services MILand the military Family Advocacy Program, child abuse and neglect generally falls into one of these four categories:

    Neglect

    Neglect includes the failure to provide for a child's basic needs despite being financially able to do so. Neglect may be:

    • Physical, when an adult fails to provide necessary food, shelter, or appropriate supervision
    • Medical, when an adult fails to provide necessary medical or mental-health treatment
    • Educational, when an adult fails to educate a child or attend to special education needs
    • Emotional, when an adult fails to provide attention to a child's emotional needs, fails to provide psychological care, or permits the child to use alcohol or drugs

    Physical Abuse

    Physical abuse  is defined as non-accidental physical harm to a child by actions such as:

    • punching
    • beating
    • kicking
    • biting
    • shaking
    • throwing
    • stabbing
    • choking
    • hitting
    • burning

    Emotional Abuse

    Emotional abuse includes a pattern of behaviors that have a negative effect on the child's psychological well-being, including constant criticism, threats, and rejection. According to the Child Welfare Information Gateway, emotional abuse may occur when a child is:

    • Ignored: An adult may not look at or respond to a child.
    • Rejected: An adult actively refuses a child by denying their needs or ridiculing them.
    • Isolated: A child is prevented from having interactions with peers, family members, or other adults.
    • Exploited or corrupted: A child is taught or encouraged to engage in illegal or inappropriate behaviors like stealing.
    • Verbally assaulted: An adult constantly belittles, shames, ridicules, or threatens a child.
    • Terrorized: An adult threatens or bullies the child and creates a climate of fear; the child or a loved one may be placed in a dangerous situation or threatened with harm.

    Sexual Abuse

    Sexual abuse includes sexual activity toward or involving a child. According to the Child Welfare Information Gateway, it may include:

    • Fondling or groping a child's genitals
    • Making a child touch an adult's sexual organs
    • Penetration of any kind that does not have a valid medical purpose
    • Incest, rape, and sodomy
    • Exposing one's self to a child
    • Exposing children to pornographic material
    • Deliberately exposing a child to the act of sexual intercourse
    • Masturbating in front of a child
    • Involving a child in prostitution
    • Involving a child in the production of any sexually explicit images

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

    Who Commits Child Abuse and Neglect?

    People who commit child abuse and neglect can come from any walk of life. Some risk factors are associated with an increased likelihood that someone might commit abuse or neglect. These include:

    • Drug and alcohol abuse
    • Difficulties controlling emotions, words, or behaviors
    • Harsh approach to discipline
    • Mental health issues
    • Little knowledge of child development
    • History of maltreatment as a child

    When a child is abused or neglected by a parent, guardian, or family member, it is called familial abuse. This type of abuse typically happens in the child’s home.

    When a child is abused or neglected by someone else in a supervisory role (like a teacher, coach, or community member), it is called institutional or out-of-home abuse. Your workplace is committed to making sure each and every child is safe while in your program. The remainder of this course will focus on ways to make sure children are never mistreated in your program. You will learn frameworks, strategies, and supports for helping to make this happen.

    What is Institutional Abuse and Neglect?

    Institutional abuse or neglect occurs outside the home in community or private settings. This type of abuse or neglect is also known as “out-of-home” or “extra-familial” abuse or neglect. Throughout the rest of this course, institutional abuse will refer to abuse or neglect which may occur in Department of Defense-sponsored facilities, programs, or activities. This course will focus on abuse or neglect which may occur in child development centers, family child care homes, sponsored field trips, and school-age care programs. Remember, though, that institutional abuse can also occur in installation homework or computer centers, mentoring or tutoring programs, sports programs, chapel programs, scouts, Morale Welfare and Recreation programs, teen centers and youth programs. This type of abuse typically involves a child and an adult in a supervisory role, like a teacher, caregiver, or volunteer.

    How Can Child Abuse and Neglect Be Prevented in Center Settings?

    The lessons that follow in this course will describe specific strategies for preventing child abuse and neglect in your program. To begin this course, though, take a few moments to think about yourself and how you can get ready for the important work you will do with children. Think about how you will go about forming a bond with each child. Consider the following relationship-building strategies:

    • Spend time with each child. If you work with infants, spend time holding, rocking, and talking to each baby. With toddlers, sit down and talk. Join in play.
    • Interact with each child. Follow a baby’s gaze and maintain eye contact. Talk to infants and copy the sounds they make. Repeat what toddlers say and add a bit more information.
    • Learn about the important people in each child’s life. Talk with family members. Learn about older siblings.
    • Provide encouragement. Help infants and toddlers explore their environments. Describe what you see them do (“You put all the balls in the basket!”) and help them bounce back from challenges (“You were working so hard to open that box. Let’s try together.”)
    • Provide comfort and touch. Infants and toddlers need positive touch. Hold babies while feeding a bottle, and rock infants to sleep. Hold or hug a crying toddler.
    • Respond quickly when an infant cries. This helps a baby learn to trust that you will meet his or her needs. Quickly providing a diaper, a bottle, or a comforting hug helps an infant build trust in adults and in the world around him.

    Next, understand that you have strengths you can draw upon to prevent child abuse and neglect. These are known as protective factors. You learned about the Strengthening Families protective factors in the Child Abuse Identification and Reporting course. You can review the Protective Factors Framework by visiting https://cssp.org/wp-content/uploads/2018/11/Branching-Out-and-Reaching-Deeper.pdf. The table below provides an overview of the protective factors that are important in your work with families and, as you will learn, important in your own efforts to prevent child abuse and neglect in center settings.

    Strengthening Families Protective Factors (Figure 1)

    1. Parental Resilience

      Families are able to manage stress and bounce back from challenges.

    2. Knowledge of Child Development and Parenting

      Adults know what to expect as children grow and are able to meet their child's needs at each stage of development.

    3. Social Connections

      Families know there are people who care about them and who they can call on for help.

    4. Concrete Supports in Times of Need

      Families can get the help they need when crises strike: food and shelter, medical and mental health services, social, legal, and educational resources.

    5. Social and Emotional Competence of Children

      Social and emotional development promotes healthy relationships with others. Children with strong relationships, who can regulate their own behavior, express their emotions, and relate to others are at lower risk of maltreatment.

    The same protective factors that help families cope with challenges apply to all of us as adults. Let’s explore each of the protective factors and how they might apply to your work. This material has been adapted from the Preventing Child Maltreatment and Promoting Well-Being: A Network for Action 2013 Resource Guide by the U.S. Department of Health and Human Services.

    • Adult Resilience: We all need the ability to cope with the stresses of everyday life. The emotions you feel may make you feel less capable of doing your job. Stress reduces your capacity to think creatively, be patient, problem solve, and try new skills – all strategies that are necessary in early childhood care. Each one of us has strengths we can draw upon: faith, flexibility, humor, communication skills, problem-solving skills, mutually supportive caring relationships, or the ability to identify and access outside resources (https://www.childwelfare.gov/topics/preventing/). We can take the time to make sure we nurture and expand these strengths in ourselves and others.
    • Knowledge of Child Development: It seems obvious, but understanding typical child development will help you do your job. Unrealistic expectations for children’s behavior are major risk factors for child abuse and neglect. Make sure you know what to expect from the children in your care. In a stressful situation, this knowledge helps you remain calm, recognize child development in action, and understand what skills you can help the child develop next. It’s also important that you continue to build your professional skills across your career. Seek out professional development and try new ideas that will keep your work fresh, exciting, and rewarding.
    • Social Connections: Research suggests that strong social connections promote health, wellness, and longevity. By creating or strengthening social relationships in your own life, you will be better able to do your job well.
    • Concrete Supports: We all need tools to help us do our jobs. It is OK — and important — to ask for help when it is needed. Talk to your trainer or supervisor about ways you can get new ideas for your classroom, individual children, or families. Also remember that you are not immune to stress outside of work, too. You might be experiencing any number of stressors at home. Seek out and use community resources, whether it’s assistance with filing taxes, finding quality health care, or job assistance for a spouse or partner.
    • Social and Emotional Competence of Children: This is the foundation of the work we do every day in child development programs. You will learn much more about this topic in the Social and Guidance courses. For now, understand your role as one of promoting healthy relationships, communication skills, and self-expression.

    See

    What do programs that prevent child abuse and neglect look like? They promote the five protective factors (the five protective factors are described in Figure 1 of this lesson's Know section). Here’s what you might see in a program that promotes the protective factors:

    • Facilitates friendships and mutual support for families Your program should provide opportunities for families to interact with one another and build relationships with one another.
    • Strengthens parenting. Everyone needs tips sometimes. Your program can offer families learning experiences right when they need them most. For example, your program could offer families of infants and toddlers information on toilet training, biting, guiding behavior etc.
    • Responds to family crises. When crises happen, families need to know there is somewhere they can go for support. Your program might not have all the answers, but it should be a place where families can connect with resources. This might be food, housing, employment, or medical services.
    • Links families to services and opportunities. Your program can connect families with parent support programs, mental health services, employment opportunities, and many other resources in our community.
    • Facilitates children’s social and emotional development. This is the foundation of everything we do in child development programs. You will learn more about how you can help children develop in this course and in the Social course.
    • Observes and responds to early warning signs of abuse and neglect. If concerns are recognized early, your program can help families build their own protective factors and get the help they need to prevent negative outcomes.
    • Values and supports parents. Your program should offer families leadership opportunities in the programs. Be sure you talk to families every day and let them know that you recognize the trust they have placed in you.

    Talk to your MILdirector or trainer PUBLICsupervisor about the supports your program offers or if you have any concerns about a family. Watch this video to learn more about the Protective Factors framework.

    Program Practices that Promote Protective Factors

    Learn about the program practices that promote protective factors

    Do

    Throughout your work with children, you should prioritize relationships. Based on what you read in this lesson, you should:

    • Establish secure bonds with children in your care.
    • Observe children for signs of child abuse or neglect (as described in the Child Abuse and Neglect Identification and Reporting course).
    • Identify the resources available for families at your program. Talk to your trainer or director to learn more.

    Completing this Course

    For more information on what to expect in this course, the Child Abuse: Prevention Competency Reflection, and a list of the accompanying Learn, Explore and Apply resources and activities offered throughout the lessons, visit the Infant & Toddler Child Abuse: Prevention Course Guide.

    Please note the References & Resources section at the end of each lesson outlines reference sources and resources to find additional information on the topics covered. As you complete lessons, you are not expected to review all the online references available. However, you are welcome to explore the resources further if you have interest, or at the request of your trainer, coach, or administrator.

      Explore

      Explore

      Think about the protective factors that you learned about in this lesson. What do you think a program looks like that embraces these protective factors? Download and print the Building a Safe Place activity. In the space provided in the attachment, describe what you think a program looks like that promotes these factors. Use words, pictures, art, or other means to represent your ideas. If you need additional space, you may use materials available at your program. Share your ideas with your trainer, supervisor, or coach. 

      Apply

      Apply

      To learn more about the Protective Factors Framework, download and print the Strengthening Families Brochure. This resource describes each of the protective factors in depth. Think about how these protective factors apply to families and yourself. 

      Glossary

      TermDescription
      Child developmentChanges that occur as children grow from birth through adolescence. The changes can be physical, mental, emotional, or social
      Protective factorsConditions or attributes in individuals, families, or communities that promote health and well-being

      Demonstrate

      Demonstrate
      Assessment

      Q1

      Shelby, a mother of 6-month-old twins in your program, seems to always have a smile on her face. Some days it’s difficult just to get the boys dressed and in the car, but Shelby always seems to bounce back from every challenge. This is an example of which protective factor?

      Q2

      Mel lost her job at the local restaurant. Although her husband works full time, they need her income to pay the bills and feed the family. Mel goes to a local employment office and talks to a counselor about ways to improve her applications and interviewing skills. An advocate there also helps her apply for assistance with the family’s utility bills. This is an example of which protective factor?

      Mel lost her job at the local restaurant. Although her husband is Active Duty, they need her income to pay the bills and feed the family. Mel goes to the Family Services Center and talks to a staff member about ways to improve her applications and interviewing skills. A personal finance manager there also helps her with budgeting. This is an example of which protective factor?

      Q3

      Desmond is a single dad. He serves in the military and is stationed far from his extended family. He participates in all the family events at the child development center and often gets together for play dates with other families from the center on Saturdays. When Desmond needs to work late or go out of town, he has a close group of neighbors who care for his daughters. This best describes which protective factor?

      Q4

      Your program offers a family resource area. It is a comfortable lounge area where families can gather, talk, and look at books or pamphlets. Information about the curriculum and child development are provided. Posters and brochures for community agencies and help-lines are available. There is a computer, phone, and private space if families need to reach out for help. It is also near the office, so families can ask questions or get help if needed. Which protective factors is your program supporting? Choose the best answer.

      Q5

      True or false? Protective factors do not apply to my own life and my family. They are only something I help families in our program promote.

      References & Resources

      Brown, C. H. (2014). The Strengthening Families Approach and Protective Factors Framwork: Branching Out and Reaching Deeper. Washington, D.C.: Center for the Study of Social Policy. Retrieved from https://cssp.org/wp-content/uploads/2018/11/Branching-Out-and-Reaching-Deeper.pdf

      Center for the Study of Social Policy. (2018). Strengthening Families: A Protective Factors Framework. Retrieved from https://cssp.org/our-work/projects/protective-factors-framework/

      Centers for Disease Control and Prevention. (2013). Violence Prevention. Retrieved from http://www.cdc.gov/violenceprevention/

      Child Welfare Information Gateway. (2016). Definitions of child abuse and neglect. Washington, DC: U.S. Department of Health and Human Services, Children's Bureau. Retrieved from https://www.childwelfare.gov/pubPDFs/define.pdf

      Felitti, Vince J. et al. (1998) Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults. American Journal of Preventive Medicine. 14, p 245-258. doi:10.1016/S0749-3797(98)00017-8 Retrieved from https://www.cdc.gov/violenceprevention/acestudy/about.html

      Harris, N. B. (2014) How Childhood Trauma Affects Health Across a Lifetime [Video file]. Retrieved from https://www.ted.com/talks/nadine_burke_harris_how_childhood_trauma_affects_health_across_a_lifetime

      Military One Source. (n.d.). Military Family Advocacy Programs. Retrieved from http://www.militaryonesource.mil/abuse/service-providers

      Seibel, N. L., Britt, D., Gillespie, L. G., & Parlakian, R. (2006). Preventing Child Abuse and Neglect. Washington, DC: Zero to Three: Center for Infants, Toddlers and Families.

      U.S. Department of Health and Human Services. (2012). Child Maltreatment 2011.

      ZERO TO THREE: Center for Infants, Toddlers and Families. (2006). The Prevalence of Child Abuse and Neglect. Retrieved from https://www.zerotothree.org/resources/91-the-prevalence-of-child-abuse-and-neglect