Physical Abuse Determination Tip Sheet

When interviewing children, the following are suggested questions. Please keep in mind the interviewer should tailor their questions by using the words the child uses to describe their “injury/mark/bruise” or the “incident” that took place that may have injured them or placed them at risk of harm:

 Did it hurt? (use the Pain Scale Tip Sheet to determine the extent of pain involved)  Did you cry when the injury occurred?  Did your injury bleed?  What did your injury look like?  Did you injury swell?  Did you take any medicine because of your injury?  Were you able to play, sit down or move around after the incident happened?  What did your mom/dad/caretaker do right after the incident?  Were you scared when the incident happened or something else?  Did your injury hurt the next day? What did it look like?  Did you go to see the doctor after your injury?  Who saw your injury such as friends, family, teachers or something else?

The following scales are provided to help you determine whether physical abuse may have occurred based KRS 600.020 (45). 0 = no abuse and 3 = a definitive finding. The more 2’s and 3’s you have, the stronger your argument will be for a substantiation for physical abuse.

Rating: 0 1 2 3

Physical Injury*  No  Injury, no  Injury that  Injury physical evidence medical attention warrants a medical requiring immediate of injury. needed. check. medical treatment. Explanation of  There is  The  The  The Injury* no evidence of explanation of explanation of explanation is CA/N. injury is plausible injury is inconsistent with and believable. questionable or the injury, facts, or incomplete. statements of others. Evidence of bruise,  No physical  A single  More than one  Multiple scratch, cut, burn, evidence of injury. bruise, scratch, bite injury from current injuries from current or other wound* mark, cut or burn or previous and previous incident. incidents.

Impact of Injury*  Child/ren  Diminished  Diminished  Diminished engaging in normal activity that normal activity that normal activity that typical activities persisted for less persisted for 1-24 persisted for more without than one hour. hours. than 24 hours. interruption. Injury Location*  No physical  Injury to  Injury to  Injury to head, evidence of injury. buttocks, arms or hands, feet, back. face, neck, genitals, legs. abdomen or ears. Pain Reported by  Child is too  Youth reports  Youth reports  Youth reports Child: young or unable pain as 3 or less on pain as between 3 pain as 8 or more to report pain. Or 10 point scale. and 7 or less on 10 on a 10 point scale. child reports no Child reports pain point scale. Child Child reports pain pain. as: reports pain as: as:

Intentionality  All interviews  Persons  There are  Interviews Associated with consistently report interviewed are inconsistent reports (except the alleged Injury. accidental injury. unsure of of accidental vs. offender) accidental nature of intended injury to consistently report injury. the child. injury due to intended actions. Alleged offender  Sought  Shows  Shows little  Caretaker is response to child immediate and concern for the concern for the most concerned injury appropriate child/ren and the child/ren. about the impact of treatment. injury. the incident on him/her.

**These physical abuse maltreatment scales were developed in collaboration with Kosair Hospital and Dr. Mary Clyde (who studied physical abuse) who worked with DCBS to identify the items in each category, and also coordinated testing of the scales in the emergency room at Kosair. **