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    Objectives
    • Identify the signs and behavioral indicators of child abuse and neglect for school-age children.
    • Identify examples of behaviors that might indicate familial and institutional abuse.
    • Observe children for signs of abuse and neglect.

    Learn

    Learn

    Know

    We all want to keep children safe. To do so, we must be able to recognize when a child is in harm’s way. Look for the following signs from the Child Welfare Information Gateway fact sheet on Child Abuse and Neglect (U.S. Department of Health and Human Services).

    The child:

    • Shows sudden changes in behavior or school performance
    • Has not received help for physical or medical problems brought to the parents’ attention
    • Has learning problems (or difficulty concentrating) that cannot be attributed to specific physical or psychological issues
    • Is always watchful, as though preparing for something bad to happen
    • Lacks adult supervision
    • Is overly compliant, passive, or withdrawn
    • Comes to the program or other activities early, stays late, or does not want to go home

    The parent:

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

    The parent and child:

    • Rarely touch or look at each other
    • Consider their relationship entirely negative
    • State that they do not like each other

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

    Asking Questions and Opening the Lines of Communication

    All children get hurt occasionally: bumps, bruises, and scrapes can be signs of a healthy and active childhood and adolescence. Sometimes, more serious accidents happen as well: a child breaks a bone playing sports or a child is involved in a car accident. Sometimes a medical condition causes symptoms that mimic abuse. For example, some skin conditions can cause marks that resemble bruises. To be most effective at protecting school-age children from child abuse and neglect, we must be able to differentiate between accidents and abuse. Conversations are a powerful tool for doing so. Whenever you notice an injury or symptom in a child, complete an incident or accident report and ask about the injury. This is a standard part of caring for children and shows you take an interest in the child’s well-being. Remember, you are not investigating the injury. You are simply doing what comes naturally when someone is hurt: asking what happened and how the person is doing. Here are some tips for asking questions:

    • Ask open-ended questions. You might say, “Ouch. That looks like it hurts. What happened?”
    • Show concern and empathy: “I bet that was pretty scary. How did it happen?”
    • Make sure it’s an OK time to talk to the family, and be prepared to get help if the family needs it. “Is it OK to ask you about Geri’s bruises? Do you have a minute?”
    • Find out if there is anything else you should know about the injuries. “I’m glad you took her to the doctor. Is there anything we should do to make her comfortable during the day? Or is there anything she shouldn’t do?”

    In most cases the school-age child or the family member will give you a clear and accurate account of what happened. You might suspect child abuse or neglect if:

    • The child’s answer and the adult’s answers do not match or if two different adults give conflicting stories about how the injury happened. For example, a child tells you the scratches on her face came from falling into a bush. When you talk to her dad later, he says she got them from a child at a birthday party.
    • The story is not consistent with the injuries. For example, a child has burn marks on his hands that look almost like gloves—his hands were clearly submerged in something hot. His mother says the child accidentally grabbed a pot off the stove, and the child just shrugs and looks away when you ask him. Accidental burn injuries usually show some kind of splatter patterns as the child pulls away.

    Risks for School-Age Children:

    Internet Predators and Cyber-Bullying

    School-age children are growing up in a world of online social networks. They may have access to websites where they have “friends” they have never actually met. You must be on the lookout for signs that a child is engaged in dangerous or inappropriate relationships online. You will learn more about this in the Safety lesson. Make sure that you monitor children’s Internet usage, and make sure they know never to meet a person they only know online. To keep children safe, make sure you:

    • Can always see the monitors when children are on computers
    • Check browser histories
    • Install software that blocks questionable content
    • Talk to school-age children about safe internet use

    Remember that many school-age children have access to the internet at all times on smartphones and handheld devices. Talk to school-age children about safe phone use and texting. Discuss boundaries related to sharing images and content. Impress upon them that once they email or text a photo, they have no control over that image. Make sure children feel safe talking to an adult if (a) they receive inappropriate content from another child or adult or (b) they are being asked to share inappropriate content or images of themselves.

    You must also be on the lookout for children who are being victimized online. This victimization can come from other children, but it can also come from adults. There have been several high-profile stories in the media of children being taunted, harassed, belittled, and insulted online. Sometimes, these stories come to light after the child commits suicide. Many victims are under the age of 12. Observe for the signs of emotional abuse that you will read about later in the lesson.

    Crushes and Predatory Relationships

    Later in the school-age period, children may begin to show an interest in sex and romantic relationships. It’s not unusual for children to have “boyfriends” and “girlfriends.” It’s also not unusual for school-age children to have crushes on teachers or school-age program staff. As a school-age staff member, you must remain alert for these situations and handle them gracefully and appropriately. You will learn about your program’s Guidance and Touch Policy later in this course. Be sure that you always act within the boundaries of that policy. Learn how to respond if an older child does something that makes you uncomfortable: sits on your lap, squeezes in next to you on the couch, or grabs your hand. Avoid being alone with a child. If you work with older school-age children or in teen programs, avoid text messaging with children or teens. Under no circumstances should you ever share images, videos, jokes, or content that are sexual or romantic in nature.

    Remember that you are working with young children and pre-teens. Although the child might have a crush, sexual activity or sexual touching is never consensual. If you suspect that a child is being sexually abused by a staff member, another adult, or a teen, you must make a report. You will learn about reporting procedures in the next lesson.

    Examples of Staff or Volunteer Behavior in Youth-Serving Organizations

     

     

    Appropriate

     

    Inappropriate or Harmful

    Verbal

    • Praise
    • Positive reinforcement for good work or behavior
    • Sexually provocative or degrading comments
    • Risqué jokes

    Physical

    • Patting a child on the back
    • Holding the hand of a young school-age child as they get off the bus
    • Brief hugging as long as the child appears comfortable and the contact is not romanticized or sexually intimate
    • Patting the buttocks
    • Intimate, romantic, or sexual contact
    • Corporal punishment
    • Showing or involving a child in pornographic activities

     

    Resources You Should Know About

     

    Your Training and Curriculum Specialist or manager can be valuable resources as you learn about the signs of child abuse and neglect. They are your first line of support. Go to them whenever you have questions or concerns.

    Your Family Advocacy Program can provide training and technical support around recognizing child abuse and neglect. Talk to your T&Cs, manager, and Family Advocacy Program representative about any questions or concerns you have.

    The Family Advocacy Program will provide more installation- and Service-specific training on local issues, protocols, and resources. You will also receive additional training from your T&Cs throughout your career. The Virtual Lab School course is just the beginning of your professional learning around reporting and preventing child abuse and neglect.

    Scope and Mission of Family Advocacy Programs

    Your FAP team can help you recognize the signs of child abuse and neglect

    You can find a quick summary of FAP roles and responsibilities as an attachment at the end of the Learn section.

    See

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

    Signs of Abuse

    You might see a child that…

    • Has unexplained burns, bites, bruises, broken bones, or black eyes
    • Has fading bruises or other marks noticeable after an absence from the program
    • Seems frightened of the parents and protests or cries when it is time to go home
    • Shrinks at the approach of adults
    • Reports injury by a parent or another adult caregiver

    You might see a parent or adult that…

    • Offers conflicting, unconvincing, or no explanation for the child's injury
    • Describes the child as "evil," or in some other very negative way
    • Uses harsh physical discipline with the child

    Examples of Familial Physical Abuse…

    Examples of Institutional Physical Abuse…

    Jordyn refuses to take off her sweatshirt although the weather is very warm. When she pushes up her sleeves you notice circular burn marks on her forearm. They are size and shape of a cigarette. She quickly sees you looking and pulls her sleeve back down.

    Several children in your school-age program have had items stolen from their backpacks. A staff member sees Greg opening a backpack that is not his. He rushes over, grabs Greg by the arm, and violently pulls him up and away from the bag.

    You might see a child that…

    • Has difficulty walking or sitting
    • Suddenly refuses to change clothes or to participate in physical activities
    • Reports nightmares or bedwetting
    • Experiences a sudden change in appetite
    • Demonstrates bizarre, sophisticated, or unusual sexual knowledge or behavior
    • Becomes pregnant or contracts a venereal disease, particularly if under age 14
    • Runs away
    • Reports sexual abuse by a parent or another adult caregiver

    You might see a parent or adult that…

    • Is unduly protective of the child or severely limits the child's contact with other children, especially of the opposite sex
    • Is secretive and isolated
    • Is jealous or controlling with family members

    Examples of Familial Sexual Abuse…

    Examples of Institutional Sexual Abuse…

    • Amelia's 19-year-old brother is coming to pick her up today. She tells a friend that she loves her brother and they have "secrets" in her room at night.
    • Jonah spent a lot of time with the pre-teen soccer coach. Now he refuses to go to soccer practice. He shrinks from the coach as soon as he approaches.
    • A staff member texts sexual pictures with an 11-year-old girl.

    You might see a child that…

    • Shows extremes in behavior, such as overly compliant or demanding behavior, extreme passivity, or aggression
    • Is either inappropriately adult (parenting other children, for example) or inappropriately infantile (frequently rocking or head-banging, for example)
    • Is delayed in physical or emotional development
    • Has attempted suicide
    • Reports a lack of attachment to the parent

    You might see a parent or adult that…

    • Constantly blames, belittles, or berates the child
    • Is unconcerned about the child and refuses to consider offers of help for the child's problems
    • Overtly rejects the child

    Examples of Familial Emotional Abuse…

    Examples of Institutional Emotional Abuse…

    • A father comes to pick Dora up from the program. He tells her to stop being "slow and stupid like her mom."
    • A 7-year-old says there is nothing he likes to do with his parents and ignores them when they arrive at the program.
    • A volunteer begins ridiculing a child when he misses a goal on the soccer field. "Your brother got all the athletic genes. You must be the runt. Go inside. You don't belong on this field with the players."
    • A staff member forces a 5-year-old child to stay in his soiled clothes after a toileting accident so he "learns a lesson."

    You might see a child that…

    • Is frequently absent
    • Begs or steals food or money
    • Lacks needed medical or dental care, immunizations, or glasses
    • Is consistently dirty and has severe body odor
    • Lacks sufficient clothing for the weather
    • Abuses alcohol or other drugs
    • States that there is no one at home to provide care

    You might see a parent or adult that…

    • Appears to be indifferent to the child
    • Seems apathetic or depressed
    • Behaves irrationally or in a bizarre manner
    • Is abusing alcohol or other drugs

    Examples of Familial Neglect…

    Examples of Institutional Neglect…

    • 10-year-old Melissa brought alcohol to the program in her backpack. She said her mom doesn't care if she drinks beer. When you call her parents, they seem disinterested.
    • Zach's mom has not brought in a replacement for his empty rescue inhaler. Zach has severe asthma and needs the medication.
    • A staff member leaves children unattended on the basketball court, and a child gets injured.
    • A staff member takes an unscheduled break and leaves children unsupervised.
     

    Recognizing Child Abuse and Neglect in School-Age Settings

    Caring for children can be a stressful job. There can be a fine line between inappropriate caregiving practices and child abuse. When in doubt, talk to your managerMIL or the FAP. In the course on Preventing Child Abuse in Center Settings, you will learn more about positive guidance and discipline strategies. Sometimes, discipline practices cross the line into maltreatment and even abuse. You will learn more about that in the next course. This lesson focuses on clear examples of child abuse or neglect in school-age programs. If you see a pattern of any of these signs or behaviors, you might suspect child abuse or neglect in your setting:

    Signs of Abuse

    Physical

    • A staff member hits or strikes a child.
    • A staff member uses corporal punishment like spanking or whipping.

    Sexual

    • A 19-year-old staff member exchanges sexual text messages with an 11-year-old girl.

    Emotional

    • A staff member publicly ridicules a child for having an accident and soiling his pants.
    • A staff member posts insulting things about a child on a social networking site.

    Neglect

    • A staff member takes an unscheduled break and leaves the program out of ratio or children unsupervised.
    • A staff member withholds food as "punishment."
    • Staff members leave children unsupervised on a field trip and a child is assaulted in a restroom by a stranger.
    • Staff members ignore a fight between two children, and a child is seriously injured.
    • A staff member leaves children unsupervised while using dangerous equipment, or the staff member does not stop dangerous behaviors while using the equipment.

    Common Conditions Mistaken for Abuse

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

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

    Cultural Practices that are Mistaken for Abuse

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

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

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

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

    Do

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

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

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

    • Get to know all of the school-age children in your care and their families. You cannot recognize a problem if you don’t know what is typical for the child. Learn children’s patterns, personalities, preferences, and abilities. Talk to families every day.
    • Learn all you can about positive youth development. Some changes in a child’s behavior can be startling—but completely typical. For example, we expect preteens to act indifferent or moody. This is often a part of puberty. Knowing these developmental stages can help you recognize when a child’s behavior goes beyond what is typically expected.
    • Attend trainings offered by your installation’s Family Advocacy Program on child abuse identification and reporting.
    • Develop respectful communication skills. If you have a concern, ask about it. Ask open-ended questions that focus on the child’s well-being. “Is it OK if I ask you about Jordan’s bruises?” or “I’ve noticed that Tasha hasn’t seemed like herself lately. Is everything OK?” If something doesn’t seem right, gather as much information as you can.
    • Keep careful records. Your observations can be an important tool for identifying child abuse and neglect. Look for signs or behavioral indicators and write down what you see or hear. Write down adults’ explanations for injuries and children’s explanations. If a pattern emerges, you will have ample evidence for making your report.
    • Learn about the cultures of the children you serve. Some cultures have rituals or healing practices that might be mistaken for signs of abuse. Ask yourMIL trainer or manager for information if you need help. When in doubt, make a report. Child Protective ServicesMIL or the Family Advocacy Program will decide whether abuse has occurred.
    • Learn reporting procedures for your stateMIL or installation. You will learn more about this in the next lesson.

     

    Explore

    Explore

    Learn more about the scenario that you read in Lesson 1. Download and print the Case Study. This time, look for the signs of abuse and neglect. Then answer the reflection questions. When you are finished, share your answers with your trainer, supervisor, or coach. Then, review the suggested responses for additional reflection on Braden and Bethany’s story.

    Apply

    Apply

    Download and print this Fact Sheet entitled Recognizing the Signs and Symptoms of Child Abuse and Neglect. Make sure you are familiar with its contents and can describe the signs of abuse and neglect that you might see.

    Glossary

    TermDescription
    Familial abuse and neglectabuse or neglect committed by a parent, guardian, or member of the family
    Institutional abuse and neglectabuse or neglect that takes place outside of the child’s home and is committed by someone in a supervisory role over the child (teacher, scout leader, etc.)
    Neglectfailure by a caregiver to provide needed, age-appropriate care although financially able to do so or offered financial or other means to do so (U.S. Department of Health and Human Services, 2007)
    Physical abusenon-accidental trauma or injury
    Sexual abusethe involvement of a child in any sexual touching, depiction, or activity
    Emotional abusea pattern of behavior by adults that seriously interferes with a child’s cognitive, emotional, psychological or social development
    Guidance and touch policyThe policy your program has developed that describes the boundaries of acceptable and unacceptable discipline procedures and ways of touching children

    Demonstrate

    Demonstrate
    Assessment

    Q1

    Which of the following scenarios might make you suspect child abuse or neglect?

    Q2

    True or false? Parents are the only people who commit child abuse or neglect.

    Q3

    A child comes in with new bruises. What should you do first?

    Q4

    Which of the following is not a sign of institutional abuse or neglect?

    Q5

    Which of the following is not a sign of familial abuse or neglect?

    References & Resources

    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/

    Centers for Disease Control and Prevention. (2007). Preventing Child Sexual Abuse within Youth-Serving Organizations: Getting Started on Policies and Procedures. Retrieved from http://www.cdc.gov/violenceprevention/pdf/PreventingChildSexualAbuse-a.pdf

    Lafontaine, K. R. (1999). Ohio State University Extension Fact Sheet: Recognizing Child Abuse and Neglect. Columbus, OH: State 4-H Office. Retrieved from https://washington.osu.edu/sites/washington/files/imce/2018%20Training%20Factsheet%20and%20Questions.pdf

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

    U.S. Department of Health and Human Services. (n.d.). Stopbullying.gov: Cyberbullying. Retrieved from https://www.stopbullying.gov/cyberbullying/what-is-it/index.html