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u.s: DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of Human Development Services National Criminal Justice Reference Service Ad.ministration for Children, Youth and Families Children's Bureau National Center on Child Abuse and Neglect hds human dev~lopment nCJrs servIces Working with State and Local Agencies to Create Caring Communities

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," Points of view or opinions stated in this document are those of the author(s) and do not represe'nt the official DATE position or policies of the U. S. Department of Justice. FILMED~

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U.S. DEPARTMENT OF HEALTH AND HUMAN S6>RVICES Office of Human Development Services ! Administration for Children, Youth and Families 1 N C J R S Children's Bureau National Center on Child Abuse and Neglect DHHS Publication No. (OHDS) 80·30137 MAR 93 1981 Issued September 1978 Revised April 1980 j J1.. CQUISITtONS \ \

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This INTERDISCIPLINARY GLOSSARY was prepared by:

MIDWEST PARENT-CHILD WELFARE RESOURCE CENTER which on September I, 1978 became the REGION V CHILD ABUSE AND NEGLECT RESOURCE CENTER Center for Advanced Studies in Human Services School of Social Welfare University of Wisconsin-Milwaukee Milwaukee, Wisconsin 53201 (414) 963-4184

Midwest Parent-Child Welfare Resource Center Staff who assumed major responsibility for this effort:

Adrienne Ahlgren Haeuser, Associate Professor and Director Kathie D. Meikamp, Assistant to the Director Barbara Perlman Weber, Glossary Project Coordinator Nancy Mack, Socretary

Material was contributed and reviewed by all Midwest Parent-Child Welfare Resource Center professional staff, Foreword including in addition to the above:

Thomas R. Bell, Information Specialist Laura Daniel, Supportive Services Coordinator The National Center on Child Abuse and Neglect was sin-Milwaukee compiled this Interdisciplinary Gloss­ Margaret Melvin, Assistant Information Specialist created by the Child Abuse Prevention and Treatment Janet Stenlund, Supportive Services Coordinator ary. It presents, in a concise and easily accessible for­ Act (PL 93-247) in 1974 to provide the first .sustained mat, legal, medical, and social work terms relevant to Mary Voght, Project Assistant focus for federal efforts to improve the plight of abuse Carolyn Kott Washburne, Associate in Family Development child abuse and neglect prevention and treatment and neglected children and their families. The National programs, and provides explanations which will facili­ Center is located in Washington, D.C., and is an tate cross-disciplinary understanding. As such, we hope organizational part of the U.S. Children's Bureau with­ it will prove helpful to: attorneys, day care personnel, in the Department of Health, Education and Welfare's family life educators, health care administrators, Administration for Children, Youth and Families of homemaker personnel, judges, law enforcement per­ the Office of Human Development Services. sonnel, legislators, nurses, parent aides, physicians, Central to the National Center's efforts is a commit­ psychologists, social planners, social workers, school ment to non-punitive, interdisciplinary and com­ administrators, teachers, students, volunteer child and munity-wide approaches. However, one of the major family advocates, and concerned citizens in all parts of constraints to this approach is that professionals often the country. have difficulty communicating across professional This publication was made possible by Grant No. 90-C-600 from the N~~ional ~enter on Child Abuse and The National Center is pleased to make this Glossary boundaries. What may be understandable within one Neglect, Children's Bureau, Administration for Children, Youth and Families, Office of Human Develop~l~nt available. profession because it is standard professional ter­ Services, U.S. Department of Health, Education and Welfare. Its contents should not be construed as offiCial minology may not be understood by persons in other policy of the National Center on Child Abuse and Neglect or any other agency of the Federal Government. professions working on the same case or program. To Director facilitate communication and understanding within National Center on Child and across disciplines, the Midwest Parent-Child For sale by the Superintendent or Documents, U.S. Government Printing Office Abuse and Neglect Washington. D.C. 20402 Welfare Resource Center at the University of Wiscon- Children's Bureau Stock No. 017·000·00206·6 iii

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Preface

A glossary, according to Webster, is an explanation of which have specific implications in the area of child foreign or technical terms. This Gio5sary explains: I) abuse and neglect, were included. terms which are unique to child abuse and neglect, and Where terms have different meanings in different . ! 2) terms used with respect to child abuse and neglect professions, all of the explanations are provided with but which also have wider application. In the former the applicable profession identified. instance, the Glossary provides exhaustive explana­ Acronyms (abbreviations) use,! commonly in profes­ tions and commentary on significant issues. In the latter sional practice appear in the body of the Glossary after instance, the Glossary provides explanations which term~ to which they refer. However, an alphabetical list may be generic or which may, because of space limita­ of these acronyms and their referrents is provided at tions, be only that explanation which is relevant to the end of the Glossary. child abuse and neglect. In most cases, the distinction is Many of the explanations of legal and medical terms self-evident, but users of this Glossary should under­ were compiled from glossaries developed by Urban stand that the Glossary is definitive only with respect to Rural Systems Associates (URSA) under grants and child abuse and neglect. contracts with the National Center on Child Abuse and Providing explanations in an area where many defini­ Neglect. Explanations of medical terms were also com­ tions have not been finalized or are subject to disciplin­ piled from glossaries developed by the National In­ ary interpretation is risky. The Midwest Parent-Child stitute of Mental Health. However, the Midwest Welfare Resource Center has assumed this burden in Parent-Child Welfare Resource Center has added the the belief that while the explanations provided here specific implications for child abuse and neglect to may not be perfect, they can nevertheless be useful to many of the medical definitions. practitioners. The goal was utility rather than perfec­ All of the social work terms and explanations were tion. The explanations do represent experts' consensus compiled by the Midwest Parent-Child Welfare and conformance with the Standards of the National Resource Center. Center on Child Abuse and Neglect. Frequency of use in practice or in professional literature guided the selection of terms for inclusion, Associate Professor and Director except that commonly used terms which are either self­ Region V Child Abuse and Neglect explanatory or satisfactorily gefined in a standard dic­ Resource Center tionary were omitted. On the other hand, terms which (Formerly) Midwest Parent-Child are commonly understood in the English language, but Welfare Resource Center v

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-'--. r r Ir 9, MIDWEST PARENT-CHILD WELFARE RESOURCE ,~ , CENTER ADVISORY COMMITTEE

The Midwest Parent-Child Welfare Resource Center Advisory Committee encouraged this project and committee members reviewed various drafts. Staff gratefully acknowledges this participation and at the same time absolves Advisory Committee members from responsibility for any shortcomings of this work.

Paul Glasser, University of Michigan, Advisory Com­ mittee Chairperson Gary Koehler, Minnesota Department of Public Welfare Robert ten Bensel, University of Minnesota Jacquie Patterson, National Urban League Central Shirley Zimmerman, University of Minnesota Regional Office Dolores Reid, Illinois Department of Children and David Schwertfager, Ohio Department of Public Family Services Welfare Robert O. Washington, Ohio State University David W. Bahlman, Indiana Lawyers Commission Mary Jo Mozingo, Indiana Department of Public Jerald Mqjerus, Wisconsin Department of Health and Welfare Social Services Margaret Moore Post, Indianapolis News A~fred Kadushin, University of Wisconsin-Madison Mary Mel O'Dowd, University of Wisconsin-M ilwaukee Carol Barnhart, Parents Anonymous of Michigan Robert Boger, Michigan State University Forrest Lewis, Region V Administration for Ch.i1dren, Youth and Families John Cole, Michigan Office of Children and Youth Services Frank Schneiger, Rutgers Medical School Shirley A. Smith, Region V Administration for Sandra Godfrey, Parents Anonymous of Michigan Children, Youth and Families Howard Wolpe, Regional Representative for U.S. Sena­ tor Donald Riegle, Jr. Roland Sneed, National Center on Child· Abuse and Neglect

The Midwest Parent-Child Welfare Resource Center is further indebted to the following persons who contributed terms and/or explanations or who reviewed and critiqued various drafts. These persons, however, are in no way responsible for any shortcomings of this work.

Edith B/ackhall, ACSW, Section Supervisor Frank Crivello, Assistant District Attorney Child Protection and Parent Services Milwaukee County District Attorney's Office Milwaukee County Department of Public Welfare Patricia S. Curley, Assistant District Attorney Philip A. Bond, M.D., Director Child Advocacy Center Milwaukee County District Attorney's Office Milwaukee Children's Hospital Harold S. Goldman, J.D., M.S.W., Technical Advisor Office of Legal Counsel Barbara Brill, Graduate Student School of Social Welfare Illinois Department of Children and Family Services University of Wisconsin-Milwaukee Frank K. Johnson, M.D., Child Psychiatrist Milwaukee County Child and Adolescent Treatment Catherine Chi/man, Ph.D., Proft::-ssor Center School of Social Welfare University of Wisconsin-Milwaukee Avis Kristenson, Professor 1

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School of Social Welfare Children's Hospital Medical Center, Boston ADVOCACY University of Wisconsin-Milwaukee to prevent neglect, abuse, and exploitation of children. Its Interventive strategy in which a helping person assumes Henry Plum, Legal Counsel objectives are to inform the public of the probkm, to pro­ Betsy Martin, Graduate Student an active role in assisting or supporting a specific child mote understanding of its causes, to advise on the iden­ School of Social Welfare Milwaukee County Department of Public Welfare and / or family or a cause on behalf of children and/ or tification and protection of abused and neglected children, families. This could involve finding and facilitating serv­ University of Wisconsin-Milwaukee and to assist in organizing new and improving existing David R. Walters, Ph.D., Associate Professor ices for specific cases or developing new services or pro­ child protection programs and services. Some of the Robert Murphy, Graduate Studeut Department of Forensic Studies moting program coordination. The advocate uses his/ her programs and services of CDAHA include research, con­ School of Social Welfare Indiana University-Bloomington power to meet client needs or to promote causes. sultation and surveys, legislative guidance, staff develop­ University of Wisconsin-Milwaukee AFFIDAVIT ment training and workshops, and publications. AHA in­ Christine I. Wnrd-Hull, Research Director cludes an Animal Division in addition to the Children's Eli H. Newberger, M.D., Director Written statement signed in the presence of a Notary Juvenile Justice Division Division. Family Development Study Public who "swears in" the signer. The contents of the Indiana Judicial Study Commission affidavit are stated under penalty of perjury. Affidavits are frequently used in the initiation of juvenile court cases and AMERICAN PUBLIC WELFARE ASSOCIATION are, at times, presented to the court as evidence. (APWA) I 125 Fifteenth St. N. W. Suite 300 Terms and Explanations AGAINST MEDICAL ADVICE (AMA) Washington, D.C. 20005 Going against the orders of a physician. In cases of child APWA was founded in 1930 and has, from its inception, abuse or neglect, this usually means the removal of a child been a voluntary membership organization composed of from a hospital without the physician's consent. individuals and agencies interested in issues of public ABANDONMENT welfare. National in scope, its dual purpose is to: 1) exert a paid post-Master's degree experience and c'ontinuous Na­ Act of a parent or caretaker leaving a child without adequ­ positive influence on the shaping of national social policy, tional Association of Social Workers (NASW) member­ ate supervision or provision for his/ her needs for an ex­ ship. AID TO FAMILIES WITH DEPENDENT and 2) promote professional development of persons cessive period of time. State laws vary in defining adequa­ CHILDREN (AFDC) (See SOCIAL SECURITY working in the area of public welfare. APW A sponsors an cy of supervision and the length of time a child may be left ACT) ACTING OUT extensive program of policy analysis and research, alone or in the care of another before abandonment is testimony and consultation, publications, conferences, determined. The age of the child also is an important fac­ I) Behavior of an abusive parent who may be un­ ALLEGATION and workshops. It works for policies which are more tor. In legal terminology, "abandonment cases" are suits consciously and indirectly expressing anger toward An assertion, declaration, or statement of a party to a legal equitable, less complex, and easier to administer in order calling for the termination of parental rights. his/ her own parents or other significant person. action, which sets out what he or she expects to prove. In a that public welfare personnel can respond efficiently and 2) Aggressive or sexual behavior explained by some child abuse or neglect case, the allegation forms the basis effectively to the needs of persons they serve. ABDOMINAL DISTENTION psychoanalytic theorists as carrying out fantasies or of the petition or accusation containing charges of specific expressing unconscious feelings and conflicts. Swelling of the stomach area. The distention may be acts of maltreatment which the petitioner hopes to prove at ANNUAL REVIEW OF DEPENDENCY CAS~S 3) Children's play or play therapy activities used as a the trial. caused by internal injury or obstruction or by malnutri­ Annual or other periodic reviews of dependency cases to tion. means of expressing hitherto repressed feelings. determine whether continued child placement or court ALOPECIA supervision of a child is necessary. Increasingly required ABRASION ACUTE CARE CAPACITY Absence of hair from skin areas where it normally ap­ by state law, such reviews by the court also provide some pears; baldness. Wound in which an area of the body surface is scraped of Capacity of a community to respo~d quickly and responsi­ judicial supervision of probation or casework services. skin or mucous membrane. bly to a report of a child abuse or neglect. It involves receiving the report and providing a diagnostic assessment AMERICAN ACADEMY OF (tEDIA TRICS (AAP) ANOMIE ABUSE (See CHILD ABUSE AND NEGLECT) including both a medical assessment and an evaluation of P.O. Box 1034 A state of anomie is characterized by attitudes of aimless­ family dynamics. It also involves rapid intervention, in­ Evanston, Illinois 60204 ness, futility, and lack of motivation and results from the ABUSED CHILD' (See INDICATORS OF CHILD cluding immediate protection of the child when needed AAP is the pan-American association of physicians cer­ breakdown or failure of standards, rules, norms, and ABUSE AND NEGLECT) and referral for long term care or service to the child and tified in the care of infants, children, and adolescents. It values that ordinarily bind people together in some his/ her family. was founded in 1930 for the primary purpose of ensuring socially organi~ed way. ABUSED PARENT "the attainment of all children of the Americas of their Parent who has been abused as a child and who therefore ADJUDICA TION HEARING full potential for physical, emotional, and social health." may be more likely to abuse his/her own child. Court hearing, in which it is decided whether or not Services and activities of AAP include standards-setting ANOREXIA charges against a parent or caretaker are substantiated by for pediatric residencies, scholarships, continuing educa­ Lack or loss of appetite for food. ABUSER, PASSIVE (See PASSIVE ABUSER) admissible evidence. Also known as jurisdictional or evi­ tion, standards-setting for child health care, community dentiary hearing. health services, consultation, publications, and research. APATHY.FUTILITY SYNDROM ACADEMY OF CERTIFIED SOCIAL WORKERS Immature personality type often associated with child (ACSW) AMERICAN HUMANE ASSOCIATION, ADMISSIBLE EVIDENCE neglect and characterized by an inability to feel and to find Professional category identifying experienced social CHILDREN'S DIVISION (AHA) Evidence which may be legally and properly used in court. any significant meaning in life. This syndrome, often aris­ workers. Eligibility is determined by written examination 5351 S. Roslyn St. (See also EVIDENCE, EVIDENTIARY STANDARDS, ing from early deprivations in childhood, is frequently following two years' full-time or 3,000 hours part-time Englewood, Colorado 80 110 EXPERT TESTIMONY) perpetuated from generation to generation within a family National association of individuals and agencies working system. (Polansky) 2 \ 3 .~ " I ~------r',.---- -~- .------,------~-

APPEAL BATTERY child maltreatment case, of producing evidence at a trial reports of suspected child abuse or neglect have been Resort to a higher court in an attempt to have a decision or Offensive contact or physical violence with a person so as to establish the truth of the allegations against the made. ruling of the lower court corrected or reversed because of without his/her consent, and which mayor may not be parent. At the commencement of a trial, it is always up to 3) Keeps all involved workers apprised of new informa­ some claimed error. or injustice. Appeals follow several preceded by a threat of assault. Because a minor cannot the petitioner to first present evidence which proves their tion. different formats. Occasionally, appeals will result in a legally give consent, any such contact or violence against a case. (See also EVIDENCE, EVIDENTIARY STAND­ 4) Calls and chairs the intial case conference for assess­ rehearing of the entire case. Usually, however, appeals are child is considered battery. The action may be aggravated, ARDS) ment, disposition, and treatment plans; conference limited to consideration of questions of whether the lower meaning intentional, or it may be simple, meaning that the may include parents, physician, probation worker, court judge correctly applied the law to the facts of the action was not intentional or did not cause severe h'\rm. police, public health nurse, private therapist, parent case. Assault is occasionally used to mean attempted battery. BURN (See also ASSAULT) Wound resulting from the application of too much heat. aide, protective service and welfare workers, or Burns are classified by the degree of damage caused. others. ASSESSMENT I st degree: Scorching or painful redness of the skin. 5) Coordinates interagency follow-up. I) Determination of the validity of a reported case of BEST INTERESTS OF THE CHILD 2nd degree: Formation of blisters. 6) Calls further case conferences as needed. suspected child abuse or neglect through investigatory Standard for deciding among alternative plans for abused 3rd degree: Destruction of outer layers of the skin. (See also PURCHASE OF SERVICE) interviews with persons involved. This could include or neglected children. This is also known as the least interviews with the family, the child, school, and detrimental alternative principle. Usually it is assumed BURN OUT (See staff burn out.) CASEWORK neighbors, as well as with other professionals and that it is in the child's best interest and least detrimental if A method of social work intervention which helps an in­ paraprofessionals having direct contact with the child the child remains in the home, provided that the parents CALCiFICA TION dividual or family improve their functioning in society by or family. can respond to treatment. However, the parents' potential Formation of bone. The amount of calcium deposited can changing both internal attitudes and feelings and.external 2) Determination of the treatment potential and treat­ for treatment may be difficult to assess and it may not be indicate via X-ray the degree of healing of a broken bone circumstances directly affecting the individual or family. ment plan for confirmed cases. known whether the necessary resources are available. A or the location of previous fractures which have healed This contrasts with community organization and other few authorities believe that except where the child's life is prior to the X-ray. methods of social work intervention which focuses on ASSAULT in danger, it is always in the child's best interest to remain changing institutions or society. Social casework relies on in the home. This view reflects the position that in evaluat­ Intentional or reckless threat of physical injury to a per­ CALLUS a relationship between the worker and client as the pri­ ing the least detrimental alternative and the child's best son. Aggravated assault is committed with the intention of New bone formed during the healing process of a fracture. mary tool for effecting change. carrying out the threat or other crimes. Simple assault is interes.t, the child's psychological as well as physical well­ being must be considered. In developing a plan, the best committed without the intention of carrying out the threat CALVARIUM CA TEGORICAL AID interest of the child may not be served because of parents' or if the attempt at injury is not completed. (See also BAT­ Dome-like portion of the skull. Government financial assistance given to individuals who TERY, SEXUAL ASSAULT) legal rights or because agency policy and practice focuses are aged or disabled or to families with dependent on foster care. The best interest of the child and least CARETAKER children. The eligibility requirements and financial assis­ detrimental alternative principles were articulated as a A person responsible for a child's health or welfare, in­ tance vary for different categories of persons, according to ATROPHY reaction to the overuse of child placement in cases of cluding the child's parent, guardian, or other person the guidelines of the Social Security Act. (See also Wasting away of flesh, tissue, cell, or organ. abuse and neglect. Whereas "best interest of the child" within the child's own home; or a person responsible for a SOCIAL SECURITY ACT) suggests that some placement may be justified, "least child's health or welfare in a relative's home, foster care A VIT AMINOSIS detrimental alternative" is stronger in suggesting that any home, or residential institution. A caretaker is responsible CENTRAL REGISTER Condition due to complete lack of one or more essential placement or alternative can have some negative conse­ for meeting a child's basic physical and psychological Records of child abuse reports collected centrally from vitamins. (See also HYPOVITAMINOSIS) quences and should be monitored. needs and for providing protection and supervision. various agencies under state law or voluntary agreement. Agencies receiving reports of suspected abuse check with BA TTERED CHILD SYNDROME BEYOND A REASONABLE DOUBT (See EVI­ CARTILAGE the central register to determine whether prior reports Term introduced in 1962 by C. Henry Kempe, M.D., in DENTIARY STANDARDS) The hard connective tissue that is not bone but, in the un­ have been received by other agencies concerning the same the Journal of the A merican Medical A ssociation in an born and growing child, may be the forerunner of bone child or parents. The purposes of central registers may be article describing a combination of physical and other BONDING before calcium is deposited in it. to alert authorities to families with a prior history of abuse, signs indicating that a child's internal and/ or external inj­ The psychological attachment of mother to child which to assist agencies in planning for abusive families, and to uries result from acts committed by a parent or caretaker. develops during and immediately following childbirth. CASE MANAGEMENT provide data for statistical analysis of child abuse. Due to In some states, the battered child syndrome ha.s been Bonding, which appears to be crucial to the development Coordination of the multiplicity of services required by a variance in state laws for reporting child abuse and judicially recognized as an accepted medical diagnosis. of a health parent/ child relationship, may be studied dur­ child abuse and neglect client. Some of these services may neglect, there are diverse methods of compiling these Frequently this term is misused or mis'!nderstood as t\:le ing and immediately following delivery to help identify be purchased from an agency other than the mandated records and of access to them. Although access to register only type of child abuse and neglect. (See also CHILD potential families-at-risk. Bonding is normally a natural agency. In general, the role of the case manager is not the records is usually restricted, critics warn of confidentiality ABUSE AND NEGLECT) occurrence but it may be disrupted by separation of provision of direct services but the monitoring of those problems and the importance of expunging unverified mother and baby or by situational or psychological factors services to assure that they are relevant to the client, reports. (See also EXPUNGEMENT) BA TTERED WOMEN causing the mother to reject the baby at birth. delivered in a useful way, and appropriately used by the Women who are victims of non-accidental physical client. To do this, a case manager assumes the following CHILD and/ or psychological injury inflected by a spouse or mate. BRUISE (See INTRADERMAL HEMORRHAGE) responsibilities. A person, also known as minor, from birth to legal age of There seems to be a relationship between child abuse and I) Ascertains that all mandated reports have been prop­ maturity for whom a parent and/ or caretaker. foster battered women, with both often occurring in the same BURDEN OF PROOF erly filed. parent, public or private home, institution, or agency is family. (See also SPOUSE ABUSE) The duty, usually falling on the state as petitioner in a 2) Informs all professionals involved with the family that legally responsible. The 1974 Child Abuse Prevention and

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Treatment Act defines a child as a person under 18. In characterized by constant verbal harassment and calise and effect relationship between the parent's CHILD HEALTH VISITOR some states, a person of any age with a developmental denigration of a child. Many persons abused as unresponsiveness and lack of nurturance and the Professional or paraprofessional who visits a home shortly disability is defined as a child. children report feeling more permanently damaged child's symptoms, and many states do not include after the birth of a baby and periodically thereafter to by verbal abuse than by isolated or repeated ex­ psychological or emotional neglect in their reporting identify current and potential child health and develop­ CHILD ABUSE (See CHILD ABUSE AND periences of physical abuse. laws. ment and family stress problems and to facilitate use of NEGLECT) needed community services. While currently operating in Child Neglect refers to an act of omission, many European countries, child health visitor programs specifically the failure of a parent or other person CHILD· ABUSE PREVENTION AND TREAT­ are rare in the U.S. because they are perceived as contrary CHILD ABUSE AND NEGLECT (CAN) MENT ACT (PUBLIC LAW 93-247) All-inclusive term, as defined in the Child Abuse Preven­ legally responsible for a child's welfare to provide for to the right to privacy and parental rights. A universal Act introduced and promoted in Congress by then U.S. tion and Treatmed Act, for "the physical or mental inj­ the child's basic needs and proper level of care with mandatory child health visitor program has, however, Senator Walter Mondale and signed into law on January ury, sexual abuse, negligent treatment or maltreatment of respect to food, clothing, shelter, hygiene, medical at­ been recommended by several authorities as the most 31, 1974. The act established the National Center on a child under the age of eighteen by a person who is tention, or supervision. Most states have neglect and/ or effective way to assure children's rights and prevent child Child Abuse and Neglect in the HEW Children's Bureau responsible for the child's welfare. There is agreement that dependency statutes; however, not all states require the abuse and neglect. Also known as Home Health Visitor. and authorized annual appropriations of between $15 ~ome parental care and supervision is essential, there is reporting of neglect. While there is agreement that some parental care and supervision is essential, there is million and $25 million through Fiscal Year 1977, but it CHILD IN NEED OF SUPERVISION disagreement as to how much is necessary for a minimally is anticipated that Congress will extend the act for several acceptable environment. disagreement as to how much is necessary for a juvenile who has committed a delinquent act and has been minimally acceptable environment. Severe neglect years. Actual appropriations have been less than found by a children's court judge to require further court sometimes occurs because a parent is apathetic, im­ authorized. The purpose of the National Center is to con­ supervision, such as I) probation, or 2) the transfer of Child A buse refers specifically to an act of commission pulse-ridden, mentally retarded, depressed, or duct and compile research, provide an information custody of the child to a relative or public;. or pdvate by a parent or caretaker which is not accidental and clearinghouse, compile and publish training materials, psychotic. welfare agency for a period of time, usually not to exceed harms or threatens to harm a child's physical or mental provide technical assistance, investigate national inci­ one year. Also known as Person in Need of Supervision hea:lth or welfare. All 50 States have a child abuse Educational Neglect dence, and fund demonstration projects related to preven­ (PINS) or Minor in Need of Supervision (MINS). reporting law with varying definitions of child abuse Failure to provide for a child's cognitive develop­ tion, identification, and treatment of child abuse and and varying provisions as to who must and may report, ment. This may include failure to conform to state neglect. In the 1974 act, not more than 20% of the ap­ CHILD NEGLECT (See CHILD ABUSE AND penalties for not reporting, and required agency action legal requirements regarding school attendance. propriated funds may be used for direct assistance to NEGLECT) following the report. Factors such as the age of the states, which must be in compliance with specific legisla­ child and the severity of injury are important in deter­ Medical Neglect tive requirements including, among others, reporting and mining abuse. Failure to seek medical or dental treatment for a investigation of suspected neglect as well as abuse, provi­ CHILD PORNOGRAPHY health problem or condition which, if untreated, sion of multidisciplinary programs, and appointment of a The obscene or pornographic photf>graphy, filming, or Physical Abuse could become severe enough to represent a danger to guardian ad litem to represent the Child in all judicial depiction of children for commercial purposes. Recent Child abuse which results in physical injury, includ­ the child. Except among religious sects prohibiting proceedings. The act emphasizes mUltidisciplinary ap­ campaigns have begun to increase public awareness of ing fractures, burns, bruises, welts, cuts, and/ or in­ medical treatment, medical neglect is usually only proaches. It also provides for funding for parent self-help this problem. Also as a result of public pressure against ternal injuries. Physical abuse often occurs in the one part of a larger fa~ily problem. projects. these materials, the federal government and some states name of dIscipline or punishment, and ranges from are currently implementing special legislation to a slap of the hand to use of objects such as straps, Moral Neglect Many persons do not understand that this act is primarily outlaw the sale and interstate transportation of por­ belts, kitchen utensils, pipes, etc. (See also BAT­ Failure to give a child adequate guidance in to support research and demonstration projects. Much nographic materials that portray children engaged in TERED CHILD SYNDROME) developing positive social values, such as parents larger amounts of funding for the ongoing provisions of explicit sexual acts. who allow or teach their children to steal. child abuse and neglect services are provided to states Psychological/Emotional Abuse through Title IV -B and Title XX of the Social Security CHILD PROSTITUTION Child abuse which results in impaired psychological Physical Neglect Act. Legislation prohibiting the use of children as growth and development. Frequently occurs as ver­ Failure to provide for a child's basic survival needs, prostitutes is currently being im plemented by the bal abuse or excessive demands on a child's perfor­ such as food, clothing, shelter, and supervision, to federal government and many states. The use of or par­ mance and results in a negative self-image on the the extent that the failure represents a hazard to the CHILD DEVELOPMENT ticipation by children in sexual acts with adults for part of the child and disturbed child behavior. May child's health or safety. Determining neglect for lack Pattern of sequential stages of interrelated physical, reward or financial gain when no force is present. occur with or without physical abuse. of supervision depends upon the child's age and psychological, and social development in the process of competence, the amount of unsupervised time, the maturation from infancy and total dependence to adult­ CHILD PROTECTIVE SERVICES or CHILD PRO­ Sexual Abuse time of day when the child is unsupervised, and the hood and relative independence. Parents need to unders­ TECTION SER VICES (CPS) Child abuse which results in any act of a sexual degree of parental planning for the unsupervised tand the level of maturity consistent with each stage of A specialized child welfare service, usually part of a nature upon or with a child. Most states define any period. For a particular kind of physical neglect in­ development and should not expect a child to display a county department of public welfare, legally responsi­ sexual involvement of a parent or caretaker with a volving failure to feed a baby or small child suffi­ level of maturity of which the child is incapable at a par­ ble in most states for investigating suspected cases of child as a sexual act and therefore abuse. The most ciently, see FAILURE TO THRIVE SYNDROME. ticular stage. Abusive or neglectful parents frequently im­ child abuse and neglect and intervening in confirmed common form is incest between fathers and pair a child's healthy growth and development because cases. Qualifi.cations of CPS workers vary, with some daughters. Psychological/Emotional Neglect they do not understand child development or are other­ counties employing CPS workers without prior human Failure to provide the psychological nurturance wise unable to meet the child's physical, social, and services training and others requiring at least a Verbal Abuse necessary tor a child) psychological growth and psychological needs at a given stage or stages of develop­ Bachelor's degree in social work. With over 3,000 A particular form of psychological/ emotional abuse development. It is usually very difficult to prove the ment. counties in the U.S., there are, many kinds of CPS

6 7 ------~------.-.-- - -- ~------

programs of varying quality. Common to most is the CHILD WELFARE RESOURCE INFO~MA TION problem of insufficient staff overburdened with ex­ EXCHANGE' Children's' ~lghts are actually exercised through adult tification, and treatment of child abuse and neglect. It cessive caseloads. This plus the pressure of CPS work A project of the Children's Bureau of the ~din,~nistra­ represent~tives and auvocates. The extent to which is often the name given to the program coordination creates stress for many CPS staff. (See also STAFF tion for Children, Youth and Families, H,EW: It is a ~hildren's rights are protected varies according to the component of the community team (see COM­ BURNOUT, STAFF FLIGHT, and STAFF source for materials on exemplary programs, curricula, individual state laws providing for the identification MUNITY TEAM). SATISFACTION) technologies, and methods which ahve brought more and treatment of child abuse and neglect. An effective and efficient services to children. i.ts·purpose unresolved issue is the conflict between children's COMMUNITY EDUCATION CHILD WELFARE AGENCY [I. is to improve the delivery of child welfare services by rights and parents' rights or rights to privacy. (See also Developed for public audiences, this type of local level A public or voluntary agency providing service to chil­ identifying successful programs, methods, research, PARENTS'RIGHTS) education provides understanding about a problem or dren in their own homes and/or in day care, and which and materials, and by assisting agencies in. ,qdapting issue of community and/or societal relevance, and in­ may be licensed to place children in foster homes, them for their own use. The Exchange disseminates in­ CHIP FRACTURE (See FRACTURE) formation about appropriate community resources and group homes, or institutions or into permanent adop­ formation it has gathered through abstracts, a bi­ services available to deal with the problem or issue. tive homes. The number of children served annually by monthly bulletin, regionai workshops~ and 'co.lloquia. CIRCUMSTANTIAL EVIDENCE. (See EVI­ Sponsored by a professional agency or citizens' group, child welfare agencies in the U.S. is estimated to be DENCE) community education is usually provided through an over one million, the majority being served by public CHILDHOOD LEVEL OF LIVING SCA.LE (CLL) ongoing speaker's bureau, through periodic lecture and agencies. Payments for foster care represent well over Instrument used to measure the level of physical and CIVIL PROCEEDING discussion meetings open to the general public or half the total of child welfare agencies' expenditures. emotional/cognitive care a child is receiving in his/her Any lawsuit other than criminal prosecutions. Juvenile offered to special groups, and/or through the local home. Rated are adequacy of food, clothing, furniture, and family court cases are civil proceedings. Also . media and other publicity devices. Child welfare agencies which meet certain standards, , ;.: etc., as-well as evidence of affection, type of discipline, called a civil action. including Standards for Protective Services, are ac­ and cultural stimulation. The scale is designed to be With reference to child abuse and neglect, it is impor­ credited by the Child Welfare League of America. It is used as a guide to assessing nurturance levels rather CLEAR AND CONVINCING EVIDENCE (See tant to combine community education with public estimated that the majority of social workers employed than as objective evidence' of neglect. EVIDENTIAR Y STANDARDS) awareness. Generally, public awareness is geared only by these accredited agencies hold a Master's degree. In to reporting child abuse and neglect, and may com­ public child welfare agencies, Master's degree social CLOTTING FACTOR municate a punitive image toward parents who abuse or workers are a minority, with specific educational re­ CHILDREN·AT·RISK Material in the blood that causes it to coagulate. Defi­ neglect their children without communicating an un­ quirements varying from state to state. However, May refer to the possibility that children in the custody ciencies in clotting factors can cause profuse internal or derstanding of the problem. unlike many other fields of social work which share of a state or county will get lost in a series of place­ external bleeding and/or bruising, as in the disease responsibility with other professions, child welfare is a ments or for other reasons not be returned to their hemophilia. Bruises or bleeding caused by such a domain for which so'cial work has been accorded major natural homes when these homes are no longer COMMUNITY NEGLECT disease may be m'istaken as resulting from abuse. responsibility. Believing that child protection is a threatening to the children's welfare. May also refer to Failure of a community to provide adequate support public child welfare agency responsibility, few private children in potentially abusive institutions, but usually and social services for families and children, or lack of COLON agencies provide it. refer to children in families-at-risk. (See also community control over illegal or discriminatory ac­ The large intestine. FAMILIES-AT -RISK) tivities with respect to families and children. CHILD WELFARE LEAGUE OF AMERICA (CWLA) CHiLDREN'S DEFENSE FUND (CDF) COMMINUTED FRACTURE (See FRACTURE) 67 Irving Place 1520 New Hampshire Ave., N.W. COMMUNITY ORGANIZATION New York, N.Y. 10003 Washington, D.C. 20036 COMMISSION, ACTS OF A social work method of achieving change in human Founded in 1920, the Child Welfare League of A non-profit organization founded in 1973. Staff in­ Overt acts by a parent or caretaker toward a child service organizations or service delivery and utilization America is a privately supported, non-sectarian cludes researchers, lawyers, and others dedicated to resulting in physical or mental injury, including but not through social planning and/or social action. This kind organization which is dedicated to the improvement of long-range and systematic advocacy on behalf of limited to beatings, excessive disciplining, or exploita­ of intervention rests explicitly or implicitly on unders­ care and services for deprived, neglected, and de­ children. CDF works at federal, state, and local levels tion. (See also CHILD ABUSE AND NEGLECT) tanding the nature of the community or service system pendent children and their families. Its program is to reform policies and practices which harmfully affect which is the target of change and on organizing mem­ directed toward helping agencies and communities in large numbers of children. Activities include investiga­ COMMISSIONER (See HEARING OFFICER) bers of the community or system to participate in the the U.S. and Canada to provide essential social services tion and public information, litigation, monitoring of change process. Professional community organizers to promote the well-being of children. CWLA is an ad­ federal agencies, and technical assistance to local COMMUNITY AWARENESS assist, but do not direct, community groups in develop­ vocate for children and families, a clearinghouse and organizations. Program priorities are to assure the A community'S level of understanding of child abuse ing community organization strategies of confronta­ forum for knowledge and experience of persons in the rights of children to proper education, adequate health and neglect. Ideally, this should, include knowledge tion, collaboration, coalition, etc. Since child abuse field, and a coordinating facility through which all con­ care, comprehensive child care and family support about the extent and nature of the problem and how to and neglect is a multidisciplinary, mUltiagency cerned with child welfare can share their efforts. services, fair and humane treatment in the juvenile use the local resources. In reality, community aware­ problem, community organization for coordination ur Programs of the League and its membership of over justice system, and the avoidance of institutionaliza­ ness tends to focus on reporting rather than treatment services is imperative. 300 affiliated public and private agencies include: ac­ tion. and prevention. creditation of agencies, adoption services, conferences, COMMUNITY SUPPORT SYSTEMS consultation, training, library/information services, CHILDREN'S RIGHTS COMMUNITY COUNCIL FOR CHILD ABUSE Community resources such as schools, public health publications, personnel servic~s, public affairs and Rights of children as individuals to the protections pro­ AND NEGLECT services, day care centers, welfare advocacy, whose legislative programs, standards development, and sur­ vided in the Constitution as well as to the care and pro­ Community group, including both professionals and utilization can aid in preventing family dysfunction and veys. tection necessary for normal growth and development. citizens, which attempts to develop and coordinate child abuse and neglect, and aid in treating identified resources and/or legislation for the prevention, iden- cases of abuse and neglect. 8 9

If ( ------,'''------~-~ -_.------'I

COMMUNITY TEAM tional fatigue, and they should have a twO' or three COMPLIANCE CONGENITAL Often used incorrectly to refer to a multidisciplinary week break from this activity every several months. I) The behavior of children who readily yield to de­ Refers to any physical condition present at birth, professional group which only diagnoses and plans However, to further relieve this stress, the diagnostic mands in an attempt to please abusive or neglectful regardless of its cause. treatment for specific cases of child abuse and neglect. team, and not the protective services workers alone, parents or caretakers. CONJUNCTIV A More accurately, a community team separates the diag­ should make and be accountable for all decisions. 2) A state child abuse and neglect law which conforms Transparent lining covering the white of the eye and nosis and treatment functions and provides a third To function effectively, this team must establish pro­ to requirements outlined in the Child Abuse Pre­ eyelids. Bleeding beneath the conjunctiva can occur component for, education, training, and public rela­ tocol, define roles of each team member;- establish vention and Treatment Act and further HEW . spontaneously or from accidental or non-accidental in­ tions. The community tream also includes a community policies and procedures, and establish a network of regulations, and which therefore permits funding jury. task force or council, including citizens as well as coordination with acute care service agencies. under this act for child abuse and neglect activities professionals from various disciplines, which coordi­ in the state. (See also CHILD ABUSE PREVEN­ nates the three community team components and advo­ Long Term Treatment Component TION,AND TREATMENT ACT) CONTRA INDICA TION cates for resources and legislation. Citizens on the com­ The long term treatment component has respon­ I Reason for not giving a particular drug or prescribing a munity team also monitor the professionals and agency sibility to review treatment needs and progress of COMPLAINT particular treatment, as it may do more harm than participants. For effective child abuse and neglect specific cases periodically, to establish treatment 1) An oral statement, usually made to the police, good. management, a community team should be established goals, to coordinate existing treatment services, and charging criminal, abusive, or neglectful conduct. for every geographic area of 400,000 to 500,000 to develop new treatment programs. This compo­ CONTUSION popu;ation, and should consist of the following compo­ nent should include supervisors and workers from 2) A district attorney's document which starts a cri­ A wound producing injury to soft tissue without a break minal prosecution. nents: supportive and advocacy services as well as from 1\.I . in the skin, causing bleeding into surrounding tissues. adult, children, and family treatment programs. The I 3) A petitioner's document which starts a civil pro­ community team must assure provision and use of i \ ceeding. In juvenile or family court, the complaint CORPORAL PUNISHMENT Identification/ DiagnostiC Team Component II~ The identification/diagnostic team component has this component. I .! is usually called a petition. Physical punishment inflected directly upon the body. primary responsibility for diagnosing actual cases of II 4) In some states, term used for a report of suspected Some abusive parents mistakenly believe that corporal child abuse and neglect among those which are Education, Training, and Public Relations Compo­ abuse or neglect. punishment is the only way to discipline children, and reported or otherwise come to their attention, pro­ nent ! some child development specialists believe that almost I If* viding acute care or crisis intervention for the child The education, training, and public relations com­ COMPOUND FRACTURE (See FRACTURE) all parents must occasionally resort to corporal punish­ in immediate danger, and developing long-term ponent has responsibility for community and profes­ Ii ment to discipline or train children. Other profes­ I t treatment recommendations. This team should be sional awareness and education. Professional educa­ sionals believe that corporal punishment is never ad­ I f \ COMPREHENSIVE EMERGENCY SERVICES multidisciplinary and should probably include a tion includes implementation and/or evaluation of ( ' (CES) visable. In a Supreme Court ruling (Ingraham vs. I 1 ~) public health nurse, pediatrician, psychologist or ongoing training programs for professionals and A community system of coordinated services available Wright, April 19, 1977), corporal punishment in the psychiatrist, lawyer, law enforcement person, case paraprofessionals. on a 24-hour basis to meet emergency needs of children schools was upheld. The Supreme Court ruled that the IJ I cruel and unusual punishment clause of the Eighth aides, and a number of child protective services , \ .\ and/or families in crisis, Components of a CES system workers. The protective services workers on the The interrelationship among these various components can include 24-hour protective services, homemaker Amendment does not apply to corporal punishment in 'diagnostic team undergo unusual physical and emo- is diagrammed below: I the schools. (See also DISCIPLINE). r services, crisis nurseries, family shelters, emergency foster care, outreach, and follow-up services. I CORTEX I CONCILIATION COURT (See COURTS) Outer layer of an organ or other body structure.

j CONCUSSION COURTS ! An injury of a soft structure resulting from violent Places where judicial proceedings occur. There is an 1 A-Identification and I-Case Coordinati~ shaking or jarring; usually refers to a brain concussion. array of courts involved with child abuse and neglect Diagnosis \. cases, partly because different states divide respon­ 2-Professional Training sibility for certain proceedings among different cQurts, B--Long-Term Treatment and Recruitment ! CONFIDENTIALITY \ . Professional practice of not sharing with others infor­ and also because tradition has established a variety of 3-Public and Professional Ii C-Education, Training, i I mation entrusted by a client or patient. Sometimes names for courts which perform similar functions. Public Relations Education, Professional t communicatio,ns from parent to physician or social Child abuse reports can result in proceedings in any of Training fl worker are made with this expectation but are later the following courts: 4-Program Coordination I used in court, and many physicians and social workers Criminal Court i are torn between legal vs. professional obligations . .1" Usually divided into superior court, which handles ~ t '; Confidentiality which is protected by statute is known National Center on Child Abuse and Neglect, 1975, Vol. 3, p. 4 i i ; felony cases, and municipal court, which handles as privileged communications. Confidentiality need misdemeanors and the beginning stages of most not obstruct information sharing with a multidisciplin­ felony cases. ary team provided that the client is advised of the shar­ ing and the team has articulated its own policy and Domestic Relations Court guidelines on confidentiality. (See also PRIVILEGED A civil court iii which divorces and divorce custody COMMUNICATIONS) hearings are held.

10 11 "--,

Family Court several days' duration to parents temporarilxunable or more extensive provision of day care services, and day DELINQUENCY A civil court which, in some states, combines the unwilling to care for their children. The primary pur­ care providers are increasingly concerned with iden­ Behavior of a minor which would, in the case of an functions of domestic relations, juvenile, and pro­ pose are child protection, stabilization of ~he home, tification and prevention of child abuse and neglect. adult, constitute criminal conduct. In some states, bate courts. Establishment of family courts is often and prevention of child abuse and neglect. delinquency also in~ludes "waywardness" or disobe­ urged to reform the presently wasteful and poorly­ DA Y TREATMENT dient behavior on the part of the child. In contrast to coordinated civil court system. Under some pro­ CUSTODY 1) Program providing treatment as well as structured dependency cases, where the parent(s) rather than the ppsals, family courts would also deal with criminal The right to care and control of a child and the duty to supervision for children with identified behavioral minor is assumed responsible, delinquency cases cases involving family relations, thus improving provide food, clothing, shelter, ordinary medical care, problems, including abused and neglected assume that the minor has some responsibility for coordination in child abuse litigation. education, and discipline for a child. Permanent legal children, while they remain in their own, foster, or his/her behavior. custody may be taken from a parent or given, up by a Court of Conciliation group homes. Day treatment services usually in­ parent by a court action (see TERMINATION OF cludecbunseling with families or caretakers with A branch of domestic relations courts in some states, PARENTAL RIGHTS). Temporary custody of a child whom the children reside. DENVER MODEL usually staffed by counselors and social workers may be granted for a limited time only, usually pending ',2) Treatment and structured activities for parents or A multidisciplinary hospital-community coalition rather than by lawyers or judges, and designed to ex­ further action or review by the court. Temporary entire families in a treatment setting from which which originated in Denver, Colorado, and which has plore and promote reconciliation in divorce cases. custody may be granted for a period of months or, in they return to their own homes evenings and become a model replicated by many other programs. the case of protective or emergency custody, for a weekends. The following diagram outlines the components: Juvenile Court period of hours or several days. Juvenile court, which has jurisdiction over minors, usually handles cases of suspected delinquency as Emergency Custody well as cases of suspected abuse or neglect. In many The ability of a law enforcement officer, pursuant to TIME PLACE FUNCTION states, terminations of parental rights occur in the criminal code, to take temporary custody of a juvenile court proceedings, but that is generally the Community Child is identified as suspected abuse or neglect. child who is in immediate danger and place him/her Hospital Child is admitted to hospital. limit of juvenile court's power over adults. 24 hours in the control of child protective services. A custody Hospital Telephone report is made to protective services. hearing must usually be held within 48 hours of such Community Home is evaluated by protective services. Probate Court action. Also known as police custody. Probate court may handle cases of guardianship and Both Dispositional conference is held. 72 hours adoption in addition to estates of deceased persons. Protective Custody Community Court is involved if needed. Emergency measure taken to detain a child, often in 2 weeks Both Implement dispositional plan. CRANIUM a hospital, until a written detention request can be 6-9 months Community Maintain case. The skull. filed. In some states, telephone communication with Both Long-term Treatment program is followed. a judge is required to authorize protective custody. Both Child is returned home when home has been made safe. CRIMINAL PROSECUTION In other states, police, social workers, or doctors the process involving the filing of charges of a crime, have statutory authority to detain minors who are in imminent danger. (See also DETENTION) followed by arraignment and trial of the defendant. Adapted from Kempe and Helfer, pp. 180-18 I. Criminal prosecution may result in fines, imprison­ ment, and/or probation. Criminal defendants are en­ CUSTODY HEARING titled to acquittal unless charges against them are Hearing, usually held in children's court, to determine proven beyond a reasonable doubt. Technical rules of who has the rights of legal custody of a minor. It may DEPENDENCY custody or emergency custody. The child may be de­ evidence exclude many kinds of proof in criminal involve one parent against the other or the parents vs. a A child's need for care and supervision from a parent tained in a foster home, group home, hospital, or other trials, even though that proof might be admissible in social service agency. or caretaker. Often a legal term referring to cases of facility. civil proceedings. Criminal defendants are entitled to a children whose natural parent(s) cannot or will not jury trial; in many civil proceedings concerning CYCLE OF CHILD ABUSE OR NEGLECT (See children, there is no right to a jury trial. properly care for them or supervise them so that the DETENTION HEARING WORLD OF ABNORMAL REARING) state must assume this responsibility. Many states A court hearing held to determine whether a child distinguish findings of dependency, for which the should be kept away from his/her parents until a full CRISIS INTERVENTION DAUGHTERS UNITED ,,~, juvenile is assumed to have little or no responsibility, trial of neglect, abuse, or delinquency allegations can Action to relieve a specific stressful situation or series Organization name sometimes used for self-help groups of problems which are immediately threatening to a from findings of delinquency, in which the juvenile is take place. Detention hearings must usually be held of daughters who have been sexually abused. within 24 hours of the filing ofa detention request. (See child's health and/or welfare. This involves alleviation deemed to be at least partially responsible for his/her Daughters United is one component of a model Child behavior. also CUSTODY) of parental stress through provision of emergency serv­ Sexual Abuse Treatment Program in Santa Clara ices in the home and/or removal of the child from the County, California. (See also PARENTS UNITED) DETENTION REQUEST home. (See also EMERGENCY SERVICES and DETENTION The temporary confinement of a person by a public A document filed by a probation officer. social worker. COMPREHENSIVE EMERGENCY SERVICES) DAY CARE authority. In a case of child abuse or neglect, a child or prosecutor with the clerk of a juvenile or fam ily A structured, supervised place for children to go more may be detained pending a trial when a detention hear­ court, asking that a detention hearing be held. and that CRISIS NURSER Y or less regularly while parents work or attend school. Facility offering short-term relief of several hours to ing indicates that it is unsafe for the child to remain in a child be detained until the detention hearing has Experts believe that family stress can be relieved by his/her own home. This is often called protective taken place. Detention requests must usually be filed 12 13

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within 48 hours of the time protective custody of the f) Discipline can lead to extrapolation and. child begins. (See also CUSTODY) generalized learning patterns; punishITIentmay DUE PROCESS availability of a reporting mechanism on a 24-hour relate only to a specific event. The rights of persons involved in legal proceedings to basis and immediate intervention. This intervention DIAGNOSTIC TEAM (See COMMUNITY g) Discipline can strengthen interpersonal bonds. be treated with fairness. These rights include the right could include hospitalization of the child, assistance in TEAM) and recognizes individual means and worth; to adequate notice in advance of hearings, the right to the home including homemakers, or removal of the punishment usually causes deterioration of rela­ notice of allegations of misconduct, the right to assis­ child from the home to a shelter or foster home. (See DIAPHYSIS tionships and is usually a dehumanizing ex­ tance of a lawyer, the right to confront and cross-ex­ also COMPREHENSIVE EMERGENCY SERV­ The shaft of a long bone. perience. amine witnesses, and the right to refuse to give self-!n­ iCES) h) Both discipline and punishment behavior pat­ criminating testimony. EMOTIONAL ABUSE (See CHILD ABUSE AND DIFFERENTIAL DIAGNOSIS terns may be transmitted to the next generation. In child abuse or neglect cases, courts are granting The determination of which of two or more diseases or more and more due process to parents in recognition of NEGLECT) conditions a patient may be suffering from by According to legal definitions applying to most schools the fact that loss of parental rights, temporarily or per­ EMOTIONAL NEGLECT (See CHILD ABUSE systematically comparing and contrasting the clinical and school districts, to accomplish the purposes of manently,is as serious as loss of liberty. However, jury findings. AND NEGLECT) education, a schoolteacher stands in the place of a trials and presumptions of innocence are s~ill afforded parent and may exercise powers of control, restraint, in very few juvenile or family court cases. DIRECT EVIDENCE (See EVIDENCE) discipline, and correction as necessary, provided that ENCOPRESIS Involuntary passage of feces. the discipline is reasonable. The Supreme Court has DUODENUM DIRECT SERVICE PROVIDERS ruled that under certain circumstances, the schools may The first portion of the small intestine which connects it ENURESIS Thpse groups and individuals who directly interact also employ corporal punishment. (See also COR­ to the stomach. with clients and patients in the delivery of health, PORAL PUNISHMENT) Involuntary passage of urine. education, and welfare services, or those agencies EARL Y AND PERIODIC SCREENING, DIAG· EPIPHYSIS which employs them. It includes, among others, police­ DISLOCA TION NOSIS, AND TREATMENT (EPSDT) Growth center near the end of a long bone. men, social workers, physicians, psychiatrists, and The displacement of a bone, usually disrupting a joint, Program enacted in 1967 under Medicaid (Title 19 of clinical psychologists who see clients or patients. which may accompany a fracture or may occur alone. the Social Security Act), with early detection of poten­ EVIDENCE tially crippling or disabling conditions among poor Any sort of proof subm itted to the court for the purpose DISCIPLINE DISPOSITION children as its goal. The establishment of EPSDT was a of influencing the court's decision. Some special kinds 1) A branch of knowledge or learning or a particular The order of a juvenile or family court issued at a result of studies indicating that physical and mental of evidence are: profession, such as law, medicine, or social work. dispositional hearing which determines whether a defects were high among poor children and that early 2) Training that develops self-control, self-sufficien­ minor, already found to be a dependent or delinquent detection of the problems and prompt receipt of health Circumstantial cy, orderly conduct. Discipline is often confused child, should continue in or return to the parental care could reduce the consequences and the need for Proof of circumstances which may imply another with punishment, particularly by abusive parents home, and under what kind of supervision, or whether remedial services in later life. Although a recent study fact. For example; proof that a parent kept a bwken who resort to corporal punishment. 'Although in­ the minor should be placed out-of-home, and in what by the Children's Defense Fund has indicated that ex­ appliance cord may connect the parent to infliction terpretations of both "discipline;' and "punish­ kind of setting: a relative's home, foster home, or in­ isting health systems are not adequate to facilitate the of unique marks on a child's body. ment" tend to be vague and often overlapping, stitution. Disposition in a civil case parallels sentencing goals of EPSDT, the program has uncovered many pre­ there is some consensus that discipline has positive in a criminal case. viously undetected or untreated health problems Direct connotations and punishment is considered among those children whom it has been able to reach. Generally consisting of testimony of the type such as negatively. Some general comparisons between the DISPOSITIONAL CONFERENCE a neighbor stating that he/she saw the parent strike terms are: A conference, preferably multidisciplinary, in which EARL Y INTERVENTION the child with an appliance cord. the child, parent, family, and home diagnostic assess­ Programs and services focusing on prevention by a) Discipline can occur before, during, and/or after ments are evaluated and decisions are made as to court relieving family stress before child abuse and neglect Hearsay an event; punishment occurs only after an event. involvement, steps needed to protect the child, and occur; for example, help-lines, Head Start, home Second-hand evidence, generally conslst1l1g of b) Discipline is based on respect for a child and type of long-term treatment. This conference should be health visitors, EPSDT, crisis nurseries. testimony of the type such as, "I heard him say ... ," his/her capabilities; punishment is based on held within the first 72 hours after hospital admission Except in certain cases, such evidence is usually ex­ behavior or events precipitating behavior. or reporting of the case. ECCHYMOSIS (See INTRADERMAL HEMOR­ cluded because it is considered unreliable and c) Discipline implies that there is an authority RHAGE) because the person making the original statement figure; punishment implies power and domi­ DISPOSITIONAL HEARING (See DISPOSI­ cannot be cross-examined. nance vs. submissiveness. TION) EDEMA d) The purpose of discipline is educational and ra­ Swelling caused by an excessive amount of fluid in tional; the purpose of punishment is to inflict body tissue. It often follows a bump or bruise but may Opinion DISTAL pain, often in an attempt to vent frustration or also be caused by allergy, malnutrition, or disease. Although witnesses are ordinarily not permitted to Far; farther from any point of reference. Opposite of anger. testify to their beliefs or opinions, being restricted proximal. e) Discipline focuses on deterring future behavior EMERGENCY CUSTODY (See CUSTODY) instead to reporting what they actually saw or heard, by encouraging development of internal con­ t. : when a witness can be qualified as an expert on a trols; punishment is a method of external con­ DOMESTIC RELATIONS COURT (See EMERGENCY SER VICES given subject, he/she can report his/her conclusions, trol which mayor may not alter future behavior. COURTS) The focus of these services is protection of a child and for example, "Based upon these marks, it is my opi'­ prevention of further maltreatment through nion as a doctor that the child must have been struck 14 15

~. .' ~------~~---.-, '-- ,

II

with a flexible instrument very much like this ap­ EXPERT WITNESS (See EXPERT TESTIMONY) more widely-known Parents Anonymous. (See also FAMILY IMPACT STATEMENT (0 pliance cord." Lawyers are sometimes allowed to '0 PARENTS ANONYMOUS) Report which assesses the effect of existing and pro­ ask qualified experts "hypothetical questions," in EXPLOITATION OF CHILDREN 2) Self-help groups for families of drug abusers. posed legislation, policies, regulations, and practices which the witness is asked to assume the truth of cer­ I) Involving a child in illegal or immoral activities on family life. The purpose is to promote legislation tain facts and to express an opinion based on those for the benefit of a parent or caretaker. This could FAMILIES·AT·RISK and policies which work for, not against, healthy family "facts." (See also EXPERT TESTIMONY) include child pornography, child prostitution, sex­ May refer to families evidencing high potential for life. At the federal level, this activity is being ual abuse, or forcing a child to steal. child abuse or neglect because of a conspicuous, severe developed by the Family Impact Seminar, George Physical 2) Forcing workloads on a child in or outside the parental problem, such as criminal behavior, substance Washington University Institute for Educational Any tangible piece of proof such as a document, X­ home so as to interfere with the health, education, abuse, mental retardation, or psychosis. More often Leadership (1001 Connecticut Ave., N.W., Suite 732, ray, photograph, or weapon used to inflict an injury. and well-being of the child. refers to families evidencing high potential for abuse or Washington, D.C. 20036). Physical evidence must usually be authenticated by a neglect because of risk factors which may be less con­ witness who testifies to the connection of the evi­ EXPUNGEMENT spicuous but multiple. These include: 1) environmental FAMILY LIFE EDUCATION dence (also called an exhibit) with other facts in the Destruction of records. Expungement may be ordered stress such as unemployment or work dissatisfaction; Programs focusing on educating, enlightening, .and sup­ case. by the court after a specified number of years or when social isolation; anomie; lack of child care resources; porting individuals and families regarding aspects of the juvenile, parent, or defendant applies for: expunge­ I and/or 2) family stress such as marital discord; family life; for example, child development classes, Evidentiary Standards ment and shows that his/her conduct has improved. Ex­ t chronically and/or emotionally immature parent with a communication skills workshops, sex education State laws differ in the quantum of evidence which is pungement also applies to the removal of an unverified history of abuse or neglect as a child; unwanted preg­ courses, or money management courses. Family life considered necessary to prove a case of child report of abuse or neglect that has been made to a nancy; colicky, hyperactive, or handicapped baby or education might well be part of every child abuse and maltreatment. Three of the most commonly used central registry. (See also CENTRAL REGISTRY) child; siblings a year or less apart; sudden changes in neglect prevention program, and may be part of the standards are; family due to illness, separation, or death; parentla ig­ treatment program for abusive or neglectful parents EXTRAVASA TED BLOOD norance of child care and child development. In­ who lack this information. Beyond a Reasonable Doubt (the standard re­ Discharge or escape of blood into tissue. . creasingly, the maternal-infant bonding process at quired in all criminal court proceedings). Evi­ childbirth is evaluated and used as one means to iden­ FAMILY PLANNING dence which is entirely convincing or satisfying to FAILURE TO THRIVE SYNDROME (FTT) I tify families-at-risk. Families thus identified should be Information and counseling provided to assist in con­ a moral certainty. This is the strictest standard of A serious medical condition most often seen in children offered immediate and periodic assistance. trolling family size and spacing of children, including all. under one year of age. An FTT child's height, weight, II referrals to various agencies such as Planned Parent­ hood. and motor development fall significantly short of the FAMILY Clear and Convincing Evidence. Less evidence average growth rates of normal children. In about 10% Two or more persons related by blood, marriage, or As a condition of receiving federal funding for AFDC than is required to prove a case beyond a reasona­ of FTT cases, there is an organic cause such as serious \ J mutual agreement who interact and provide one (see SOCIAL SECURITY ACT), states are required to ble doubt, but still an amount which would make heart, kidney, or intestinal disease, a genetic error of ( another with mutual physical, emotional, social, and/or offer family planning services to applicants designated one confident of the truth of the allegations. metabolism, or brain damage. All other cases are a economic care. Families can be described as "ex­ as "appropriate." Family planning should be part of a result of a disturbed parent-child relationship tended," with more than one generation in a household; . child abuse and neglect prevention program. Preponderance of the Evidence (the standard in manifested in severe physical and emotional neglect of or "nuclear," with only parent(s) and child(ren). most civil court proceedings). Merely presenting the child. In diagnosing FTT as child neglect, certain Families can also be described as "mixed" or "multi­ FAMILY POLICY a greater weight of credible evidence than that criteria should be considered: racial"; "multi-parent," as in a commune or collective; Generally refers to public social and economic policies presented by the opposing party. This is the or "single-parent." These types are not mutually ex­ that centrally affect families. There is considerable I) The child's weight is below the third percentile, but easiest standard of proof of all. clusive. confusion about the term, with some persons believing substantial weight gain occurs when the child is that family policy should mean more direct policies. properly nurtured, such as when hospitalized. EXHIBIT FAMILY COURT (See COURTS) affecting families, such as family planning policies. 2) The child exhibits developmental retardation Physical evidence used in court. In a child abuse case, There is much more agreement that we should look at which decreases when there is adequate feeding an exhibit may consist of X-rays, photographs of the FAMILY DYNAMICS the impact of numerous policies on families, and that and appropriate stimulation. child's injuries, or the actual materials presumably Interrelationships between and among individual these should include a wide range of governmental 3) Medical investigation provides no evidence that used to inflict the injuries. (See also EVIDENCE) family members. The evaluation of family dynamics is policies. (See also FAMILY IMPACT STATEMENT) disease or medical abnormality is causing the 1\ an important factor in the identification, diagnosis, and symptoms. EXPERT TESTIMONY II treatment of child abuse and neglect. FAMILY SHELTER 4) The child exhibits clinical signs of deprivation Witnesses with various types of expertise may testify in A 24-hour residential care facility for entire families. which decrease in a more nurturing environment. IJ child abuse or neglect cases; usually these expert wit­ FAMILY DYSFUNCTION The setting offers around-the-clock care, and often 5) There appears to be a significant environmental nesses are physicians or radiologists. Experts are Ineffective functioning of the family as a unit or of in­ provides diagnosis and comprehensive treatment on a psychosocial disruption in the child's family. usually questioned in court about their education or ex­ dividual family members in their family role because of short-term basis. In child abuse and neglect, a family perience which qualifie.s them to give professional opin­ physical, mental, or situational problems of one or shelter is used primarily for crisis intervention. FAMILIES ANONYMOUS ions about the matter in question. Only after the hear­ more family members. A family which does not have or 1) Name used by the National Center for the Preven­ \ ing officer determines that the witness is, in fact, suffi­ use internal or external resources to cope with its FAMILY SYSTEM tion and Treatment of Child Abuse and Neglect at ciently expert in the subject matter may that witness problems or fulfill its responsibilities to children may The concept that families operate as an interacting Denver for self-help groups for abusive parents. proceed to state his/her opinions. (See also EVI­ be described as dysfunctional. Child abuse and neglect whole and are an open system, so that many factors in These groups operate in much the same way as the DENCE) is evidence of family dysfunction. the environment affect the functioning of family mem- 16 17 ~------r, ------

r I I bers and the interaction among members. It is also con­ establishing evidence for legal proceedings. '/ ceptualized that the behavior of the family as an in­ See diagram on next page for names and locations of children and to encourage parent participation in their teracting unit has an effect on a number offactors in the FOSTER CARE the major bones of the human skeleton. children's development. outer environment. A form of substitute care for children who need to be removed from their own homes. Usually this is a tem­ Through federal policy instructions (see Federal FAMILY VIOLENCE FRONTAL porary placement in which a child lives with a licensed Referring to the front of the head; the forehead. Register, January 26, 1977), all Head Start staff are· Abusive or aggressive behavior between parents, foster family or caretaker until he/she can return to mandated to report suspected cases of child abuse and known as wife battering or spouse abuse; between his/her own home or until reaching the age of majority. FUNDASCOPIC EXAM neglect. These policy instructions supersede individual . children, known as sibling abuse; and/or between Foster care all too often becomes a permanent method Opthalmic examination to determine if irregularities or child abuse and neglect reporting laws in states which parents and children within a family, usually child oftreatment for abused or neglected children. Effective internal injuries to the eye exist. do not include Head Start staff as mandated reporters. abuse. This behavior is related to factors within the foster care ideally includes service to the child; service structure of a family system and/or society; for exam­ to the natural parents, service to the foster parents, and GA TEKEEPERS HEARING ple, poverty, models of violent behavior displayed via periodic review of the placement. Professionals and the agencies which employ them who Judicial proceeding where issues offact or law are tried mass media, stress due to excessive numbers of are in frequent or periodic contact with families or and in which both parties have a right to be heard. A children, values of dominance and submissiveness, and FOSTER GRANDPARENTS children and who are therefore in an advantageous hearing is synonymous with a trial. attitudes toward discipline and punishment. It may also Retired persons or senior citizens who provide nur­ position to spot individual and family problems, in­ occur as a result of alcoholism or other substance; turance and support for children to whom they are not HEARING OFFICER abuse. cluding child abuse and neglect, and make appropriate related, including abused and neglected children, by referrals for early intervention or treatment. A judge or other individual who presides at a judicial . babysitting or taking them for recreational outings. proceeding. The role of judge is performed in some The terms family violence and domestic violence are This enables parents to have some respite and allows GLUTEAL juvenile court hearings by referees or commissioners, sometimes used interchangeably but some persons ex­ retired or older persons an opportunity to become in­ Related to the buttocks, which are made up of the large whose orders are issued in the name of the supervising clude child abuse from the definition of domestic volved in community activities. Sometimes foster '. gluteus maximus muscle&. judge. Acts of a referee or commissioner may be un­ violence and limit it to violence between adult mates or grandparents are volunteers and sometimes they are done after the supervising judge has conducted a spouses. paid by an agency program. GONORRHEA (See VENEREAL DISEASE) rehearing in the case.

FEDERAL REGULATIONS FOUNDED REPORT GRAND ROUNDS HELPLINE Guidelines and regulations developed by departments Any report of suspected child abuse or neglect made to Hospital staff meetings for presentation and discussion Usually a telephone counseling, information, and refer­ or agencies of the federal government to govern the mandated agency which is confirmed or verified. of a particular case or medical problem. ral service characterized by caller anonymity, late hour programs administered or funded by those agencies. Founded reports outnumber unfounded reports. availability, and the use of trained volunteers as staff. Regulations specify policies and procedures outlined in The goal is usually early intervention in any kind of a more general way in public laws or acts. Proposed FRACTURE GUARDIAN family stress, as well as crisis intervention in child federal regulations, or changes in existing regulations, A broken bone, which is one of the most common inj­ Adult charged lawfully with the responsibility for a abuse and neglect. Helplines relieve social isolation are usually published in the Federal Register for public uries found among battered children. The fracture may child. A guardian has almost all the rights and powers and offer ways of ventilating stress which are not . review and comment. They are subsequently published occur in several ways: of a natural parent, but the relationship is subject to destructive. Unlike hot lines, helplines generally cannot in the final form adopted by the governing agency. termination or change. A guardian mayor may not also report cases of child abuse and neglect since they do not Chip Fracture have custody and therefore actual care and supervision know the caller's name. Instead, the helpline attempts FEDERAL STANDARDS (See STANDARDS) A small piece ()f bone is flaked from the major part of the child. to have the caller himself/herself seek professional of the bone. assistance and/or maintain a reguiar calling relation­ FELONY ship for support and as an alternative to violent Comminuted Fracture A serious crime for which the punishment may be im­ GUARDIAN AD LITEM (GAL) behavior. Helplines appear to be very cost effective in prisonment for longer than a year and/or a fine greater Bone is crushed or broken into a number of pieces. Adult appointed by the court to represent the child in a the preventive of child abuse and neglect. Major disad­ than $1,000. Distinguished from misdemeanor or in­ judicial proceeding. The guardian ad litem may be, but vantages are lack of visual cues to problems and fraction, both of lesser degree. Compound Fracture is not necessarily, an attorney. Under the Child Abuse limited opportunity for follow-up services. (See also Fragment(s) of broken bone protrudes through the Prevention and Treatment Act, a state cannot qualify HOTLINE) FIFTH AMENDMENT skin, causing a wound. for federal assistance unless it provides by statute "that The Fifth Amendment to the U.S. Constitution guaran­ in every case involving an abused or neglected child Simple Fracture tees a defendant that he/she cannot be compell.ed to which results in a judicial proceeding a guardian ad HEMA TEMESIS present self-incriminating testimony. Bone breaks without wounding the surrounding. litem shall be appointed to represent the child in such Vomiting of blood from the stomach, often resulting tissue. proceedings." Some states have begun to allow a GAL from internal injuries. FONTANEL Spiral Fracture for children in divorce cases. The soft spots on a baby's skull where the bones of the HEMATOMA Twisting causes the line of the fracture to encircle skull have not yet grown together. A swelling caused by a collection of blood in an the bone like a spiral staircase. HEAD START enclosed space, such as under the skin or the skull. A nationwide comprehensive program for disadvan­ FORENSIC MEDICINE Torus Fracture taged preschool children, funded by the HEW Ad­ That branch of the medical profession concerned with A folding, bulging, or buckling fracture. ministration for Children, Youth and Families to meet HEMATUREA the educational, nutritional, and health needs of the Blood in the urine. 18 19 ,."- +, ~ .--~"-~ " -"------.,

HEMOPHILIA HYPOACTIVE Hereditary blood clotting disorder characterized by Less active than is considered normal. fer red upon a witness in order to obtain vital cest is not considered child sexual abuse unless a minor spontaneous or traumatic internal and external bleed­ testimony. Thereafter, the witness cannot be is involved. (See also CHILD ABUSE AND ing and bruisirig. HYPOTHERMIA prosecuted with the use of information he/she NEGLECT, SEXUAL ABUSE, SEXUAL MISUSE) Condition of low body temperature. disclosed in his/her testimony. If an immunized HEMOPTYSIS witness refuses to testify, he/she can be imprisoned INCIDENCE for contempt of court. Spitting or coughing blood from the windpipe or lungs. HYPOVITAMINOSIS The extent to which a problem occurs in a given Condition due to the deficiency of one or more essen­ population. No accurate or complete data is available IMPETIGO HEMORRHAGE tial vitamins. (See also A vn AMINOSIS) on the actual incidence of child abuse and neglect in the The escape of blood from the vessels; bleeding. A highly contagious, rapidly spreading skin disorder U.S. because major studies have not been able to obtain IDENTIFICA TION OF CHILD ABUSE AND which occurs principally in infants and young children. data from some states or have found the data not to be HOME HEALTH VISITOR (See. CHILD NEGLECT The disease, characterized by red blisters, may be an comparable. For continuing efforts to solve this HEALTH VISITOR) Diagnosis or verification of child abuse and neglect indicator of neglect and poor living conditions. problem, see NATIONAL STUDY ON CHILD cases by mandated agency workers or a diagnostic team ABUSE AND NEGLECT REPORTING. Informed HOME START following investigation of suspected child abuse and IMPULSE-RIDDEN MOTHER estimates of incidence range from 600,000 to om A nationwide home-based program funded by the neglect (see INDICATORS OF CHILD ABUSE AND Term often used to describe one kind of neglectful million cases of child abuse and neglect per year in this HEW Administration for Children, Youth and NEG LECT). Identification of child abuse and neglect parent who demonstrates restlessness, aggressiveness, country. It is generally agreed that child neglect is lour Families to strengthen parents as educators of their therefore depends not only on professional diagnostic inability to tolerate stress, manipulativeness, and crav­ to five or more times more common than child abuse. own children. skill but also on the extent to which the public and ing for excitement or change. This parent may have a Incidence of actual child abuse and neglect ~hQuld not professionals report suspected cases. Public awareness lesser degree of early deprivation than the apathetic­ be confused with the number of reported cases in a HOMEMAKER SER VICES campaigns are important to efft;:ct identification, but at i futile parent, b'ut lacks self-control over strong im­ central registry, since the latter incl ude reports of Provision of assistance, support, and relief for parents the same time it is important to have sufficient staff in I pulses and/or has not learned limit-setting. suspected but unconfirmed cases. On the other hand , it who may be unable or unwilling to fulfill parenting the mandated agency to handle all the reports a public is generally agreed that because of insufficient report­ IN CAMERA functions because of illness or being overwhelmed with awareness campaign may generate (see COMMUNITY ing, the number of actual cases coming to the attention parenting responsibilities. A homemaker is placed in a AWARENESS and COMMUNITY EDUCATION). Any closed hearing before a judge in his chambers is of local agencies is but a small proportion of the actual said to be in camera. home on an hourly or weekly basis and assists with More reporting and therefore identification will also number of cases in the popUlation. (See also housekeeping and child care while demonstrating occur as states strengthen their reporting laws so as to I CENTRAL REGISTRY and IDENTIFICATION OF 'parenting skills and providing some degree of nur­ extend the number of persons who must report and IN LOCO PARENTIS If CHILD ABUSE AND NEGLECT) turance for parents and children. penalize them mOorte heavily if they don't. It is generally I "In the place of a parent." Refers to actions of a guar­ agreed that to date the identification of child abuse and dian or other non-parental custodian. INDICA TED CHILD ABUSE AND NEGLECT HOSPITAL HOLD neglect represents only a small proportion t.>fthe actual 1) In some state statutes, "indicated" child abuse and Hospitalization for further observation and protection incidence of the problem. It is also generally agreed INCEST neglect means a confirmed or verified case. . of a child suspected of being abused or neglected. This that a greater degree of identification occurs in Sexual intercourse between persons who are closely re­ 2) Medically, "indicated" means a probable case. usually occurs when a suspected case is discovered in minority and low income groups because these persons lated. Some state laws recognize incest only as sexual an emergency room. In most cases, holding the child is are more visible to agencies and professionals required intercourse among consaguineous, or blood, relations; againsl the wishes of the parent or caretaker. (See also to report. The incidence is probably as high in upper other states recognize incest as sexual relations betwp.en INDICATORS OF CHILD ABUSE AND CUSTODY) socio-economic groups, but identification is more a variety of family members related by blood.and/or NEGLECT difficult, particularly because private physicians law. In the U.S., the prohibition against incest is Signs or symptoms which, when found in various com­ generally dislike to report. specified by many states' laws as well as by cultural tra­ HOTLINE binations, point to possible abuse or neglect. See chart dition, with state laws usually defining incest as mar­ on next page for common indicators of child abuse and Twenty-four hour statewide or local answering service ILEUM riage or sexual relationships between relatives who are neglect. for reporting child abuse or neglect and initiating in­ Final portion of the small intestine which connects with closer than second, or sometimes even more distant, vestigation by a local agency. This is often confused the colon. cousins. While incest and sexual abuse are sometimes INDICTMENT with a helpline. (See also HELPLINE) thought to be synonymous, it should be realized that in­ The report of a grand jury charging an adult with cri­ IMMUNITY, LEGAL cest is only one aspect of sexual abuse. Incest can occur HYPERACTIVE minal conduct. The process of indictment by secret Legal protection from civil or criminal liability. within families between members of the same sex, but More active than is considered normal. the most common form of incest is between father and grand jury proceedings by-passes the filing of a cri­ 1) Child abuse and neglect reporting statutes often minal complaint and the holding of a preliminary hear­ confer immunity upon persons mandated to report, daughters. It is generally agreed that incest is much HYPERTHERMIA more common than the number of reported cases indi­ ing in municipal court, so that prosecution begins im­ giving them an absolute defense to libel, slander, mediately in superior court. Condition of high body temperature. invasion of privacy, false arrest, and other lawsuits cates. Also, because society has not until the present which the person accused of the act might file. done much about this problem, professionals have HYPHEMA Some grants of immunity are limited only to those generally not had adequate training to deal with it, and INFANTICIDE Hemorrhage within the anterior chamber of the eye, persons who report in good faith and without the way the problem is handled may prove more The killing of an infant or many infants. Until modern often appearing as a bloodshot eye. The caust> could be malicious intent. traumatic for a child victim of incest than the incest ex­ times, infanticide was an accepted method of popula­ a blow to the head or violent shaking. 2) Immunity from criminal liability is sometimes con- perience itself. It should be notted that sexual relations tion control. It often took the form of abandonment. A between relatives may be defined as incest, but that in- few primitive cultures still practice infanticide. 20 ,21

, - , L: ------.~ ------._------r r

Indicators of Child Abuse and Neglect

CATEGORY CHILD'S APPEARANCE CHILD'S BEHAVIOR CARETAKER'S BEHAVIOR

Physical Abuse -Bruises and welts (on the face, lips, or mouth; in various stages of ' -Wary of physical contact with adults. -Has history of abuse as a child. healing; on large areas of the torso, back, buttocks, or thighs; in -Apprehensive when other children -Uses harsh discipline inappropriate to unusual patterns, clustered, or reflective of the instrument used cry. child's age, transgression, and condition. to inflict them; on several different surface areas), -Demonstrates extremes in behavior -Offers illogical, unconvincing, contradictory, -Burns (cigar or cigarette burns; glove or sock-like burns or dough- (e.g., extreme 'aggressiveness or or no explanation of child's injury. nut shaped burns on the buttocks or genitalia indicative of immer- withdrawal). -Seems unconcerned about child. sion in hot liquid; rope burns on the arms, legs, neck or torso; -Seems frightened of parents. -Significantly misperceives child (e.g., sees patterned burns that show the shape of the item (iron, grill, -Reports injury by parents. him as bad, evil, a monster, etc.). etc.) used to inflict them). -Psychotic or psychopathic. -Fractures (skull, jaw, or nasal fractures; spiral fractures of the -Misuses alcohol or other drugs. long (arm and leg) bones; fractures in various states of healing; -Attempts to conceal child's injury or to multiple fractures; any fracture in a child under the age of two). protect identity of person responsible. -Lacerations and abrasions (to the mouth, lip, gums, or eye; to the external genitalia). -Human bite marks.

Neglect -Consistently dirty, unwashed, hungry, or inappropriately dressed. -Is engaging in delinquent acts (e.g., -Misuses alcohol or other drugs. -Without supervision for extended periods of time or when engaged vandalism, drinking, prostitution, -Maintains chaotic home life. in dangerous activities. drug use, etc.) -Shows evidence of apathy or futility. -Constantly tired or listless. -Is begging or stealing food. -Is mentally ill or of diminished intelligence. -Has unattended phYSical problems or lacks routine medical care. -Rarely attends school. - -Has long-term chronic illnesses. -Is exploited, overworked, or kept from attending school. -Has history of neglect as a child. -Has been abandoned.

Sexual Abuse -Has torn, stained, or bloody underclothing. -Appears withdrawn or engages in -Extremely protective or jealous of child. -Experience pain or itching in the 'genital area. fantasy or infantile behavior. -Encourages child to engage in prostitution -Has bruises or bleeding in external genitalia, vagina, or anal -Has poor peer relationships. or sexual acts in the presence of caretaker. regions. -Is unwilling to participate in physical -Has been sexually abused as a child. -Has venereal disease. activities. -Is experiencing marital difficulties. -Has swollen or red cervix, vulva, or perineum. -Is engaging in delinquent acts or runs -Misuses alcohol or other drugs. -Has semen around mouth or genitalia or on clothing. away. -Is frequently absent from the home. -Is pregnant. -States he/she has been sexually assaulted by parent/caretaker.

Emotional Maltreatment -Emotional maltreatment, often less tangible than other forms -Appears overly compliant, passive, -Blames or belittles child. of child abuse and neglect, can be indicated by behaviors of undemanding. -Is cold and rejecting. the child and the caretaker. -Is extremely aggressive, demanding, -Withholds love. or rageful. -Treats siblings unequally. -Shows overly adaptive behaviors, -Seems unconcerned about child's problem. either inappropriately adult (e.g., I ".' parents other children) or inappro- priately infantile (e.g., rocks con- stantly, sucks thumb, is enuretic). -Lags in physical, emotional, and in- tellectual development. Attempts suicide. r

r INSTITUTIONAL CHILD ABUSE AND NEGLECT INVOLUNTARY PLACEMENT I) Abuse and neglect as a result of social or institu­ Court-ordered assignment of custody to an agency and tional policies, practices, or conditions. The rather placement of a child, often against the parents' wishes, widespread practice of detaining children in adult after a formal court proceeding, or the taking of )1 jails is one example. Usually refers to specific in­ emergency or protective custody against the parents' stitutions or populations, but may also be used to wishes preceding a custody hearing. (See also mean societal abuse or neglect. (See also CUSTODY) SOCIETAL ABUSE AND NEGLECT) 2) Child abus~ and neglect committed by an employee JEJUNUM of a. public or private institution or group home Middle portion of the small intestine between the against a child in the institution or group home. duodenum and the ileum. INTAKE JURISDICTION Process by which cases are introduced into an agency. The power of a particular Court to hear case" involving , Workers are usuaHy assigned to interview persons seek­ certain categories of persons or allegations. Jurisdic­ . 'jng help in ord,er to determine the nature and extent of tion may also depend upon geographical factors such as the problem(s). However, in child abuse and neglect, the county of a person's residence. (See also COURTS) intake of reports of suspected cases is usually by JURY telephone and an interview with the reporting person is ' .. not required. Child abuse and neglect workers Who do Group of adults selected by lawyers who judge the intake must be skiHed in getting as much information as truth of allegations made in a legal proceeding. Trial possible from the reporter in order to determine by jury is available in all criminal cases, including cases whether the situation is an emergency requiring instant of suspected child abuse and neglect. Very few attention. juvenile, probate, or domestic relations court cases can be tried before a jury and are instead decided by the INTERDISCIPLINARY TEAM (See COM­ presiding judge. MuN
Ty TEAM) JUVENILE COURT (See COURTS) INTRADERMAL HEMORRHAGE Bleeding within the skin; bruise. Bruises are common injuries exhibited by battered children, and are usually JUVENILE JUDGE classified by size: Presiding officer of a juvenile court. Often in a juvenile Petechiae court, there are several other hearing officers of lesser rank, usually called referees or commissioners. (See Very small bruise caused by broken capillaries. also HEARING OFFICER) Petechiae may be traumatic in nature or may be caused by clotting disorders. LABELING Purpura The widespread public and professional practice of PeteChiae occurring in groups, or a small bruise (up affixing terms which imply serious or consistent de­ to I cm. in diameter). viance to the perpetrators and/or victims of child abuse and neglect; for example, "child abuser." Since de­ :,.. EcchYmosis viance may suggest that punishment is warranted, this Larger bruise. kind of labeling decreases the possibility of treatment. This is unfortunate, because experts agree that 80% or INVOLUNTARY CLlt-NT 85% of all child abuse and neglect cases have the po­ Person who has been referred or court-ordered for tential for successful treatment. Such labeling may also services but Who has not asked for help. Most abusive make parents see themselves in a negative, despairing and neglectful parents are initially involuntary clients way, and discourage them from seeking assistance. and may not accept the need for services. They may deny that there is a problem and resist assistance. LABORATORY TESTS Motivation for change may be minimal or nonexistent; Routine medical tests used to aid diagnosis. Those par­ howevert skillful workers have demonstrated that ticularly pertinent to chilJ abuse are: motivation can be developed and treatment can be effective. Partial Thromboplastin Time (PTT) Measures clotting factors in the blood. 23 ------~------...,...------~---

Prothrombin Time (PT) have the assistance of legal counsel in all child assist in the training of the local unit and other Measures clotting factors in the blood. protective proceedings. . child protective services unit with sufficient and qualified staff. community service systems. 6) Each party should have the right to appeal pro­ 15) The agency should promote internal agency Urinalysis tective case determinations. 2) The local agency in cooperation with the state department should allocate sufficient funds coordination. Examination of urine for sugar, protein, blood, etc. 7) Any person identified in a child abuseor< neglect 16) The local unit should implement community report should be protected from unauthorized and provide adequate administrative support to the local unit. education and awareness. Complete Blood COUllt (CBC) disclosure of personal information contained in 17) The agency should participate in or initiate its Measure and analysis of red and white blood cells. the report. 3) The local agency should initiate the establish­ ment of a community council which is to be own research, rev iew, and eval uat ion stud ies. Rumpel-Leede (Tourniquet) Test LESION representative of those persons providing or (See also STATE AUTHORITY) Measures fragility of capillaries and/or bruisability. Any injury to any part of the body from any cause that concerned with child abuse and neglect pre­ results in damage or loss of structure or function of the vention, identification, and treatment services. LONG BONE LACERATION body tissue involved. A lesion may be caused by General term applied to the bones of the leg or the arm. A jagged cut or wound. poison, infection, dysfunction, or violence, and may be Primary Prevention either accidental or intentional. 4) The local unit and the community council LONG TERM TREATMENT LA TCH KEY CHILDREN should work together to establish formalized Supportive and therapeutic services over a period of Working parents' children who return after school to a needs assessment and planning processes. LIABILITY FOR FAILURE TO REPORT time, usually at least a year, to restore the parent(s) of home where no parent or caretaker is present. This State statutes which require certain categories of per­ an abused or neglected child and/or the child him­ term was coined because these children often wear a sons to report cases of suspected child abuse and/or Secondary and Tertiary Prevention 5) The local unit and the community council self/herself to adequate levels of functioning and to house key on a chain around their necks. neglect are often enforced by the imposition of a i '< prevent recurrence of child abuse or neglect. penalty, fine and/or imprisonment, for those who fail to should work together to develop a comprehen­ LATERAL report. Recent lawsuits have provided what may sive and coordinated service delivery system for children-at-risk and families-at-risk to be LUMBAR Toward the side. become an even more significant penalty for failure to Pertaining to the part of the back and sides between the report: when a report should have been made and a presented in an annual plan. lowest ribs and the pelvis. LA Y THERAPIST (See PARENT AIDE) child comes to serious harm in a subsequent incident of 6) The local unit and the community council abuse or neglect, the person who failed to report the should develop standards· on the care of MALNUTRITION LEAST DETRIMENTAL ALTERNATIVE (See initial incident may be held civilly liable to the child children which represent the minimum expec­ tations of the community and provide the basis . Faqure to receive adequate nourishment. Often ex­ BEST INTEREST OF THE CHILD) for the damages suffered in the subsequent incident. hibited in a neglected child, malnutrition may be Such damages could amount to many thousands of dol­ for the local unit's operational definitions and caused by inadequate diet (either lack of food or in­ LEGAL RIGHTS OF PERSONS IDENTIFIED IN lars. (See also MANDATED REPORTERS) referral guidelines. sufficient amounts of needed vitamins, etc.) or by a REPORTS 7) The local unit and the community council disease or other abnormal condition affecting the Standards for legal rights stress the need for all persons LICENSING PARENTHOOD should establish a multidisciplinary child body's ability to properly process foods taken in. concerned with child abuse and neglect to be aware of Proposed method of assuring adequate parenting skills. abuse and neglect case consultation team. the legal rights of individuals identified in reports and Various proposals have been developed, including 8) The local unit should provide or arrange for MALTREA TMENT to be committed to any action necessary to enforce mandatory parenthood education in high school, with a services to assist families who request help for Actions that are abusive, neglectful, or otherwise these rights. According to the National Center on Child certificate upon completion. Serious advocates com­ themselves in fulfilling their parenting respon­ threatening to a child's welfare. Frequently used as a Abuse and Neglect Revision to Federal Standards on pare the process with certification of driving capability sibilities. general term for child abuse and neglect. the Prevention and Treatment of Child A buse and by driver's licenses. Many consider the proposal un­ 9) The local unit should ensure that reports of Neglect (Draft), these rights include the following: workable. child abuse and neglect can be received on a twenty-four hour, seven days per week basis. MANDA TED AGENCY Agency designated by state statutes as legally responsi­ 1) Any person identified in a report as being LOCAL AUTHORITY 10) The intake services worker should intervene ble for receiving and investigating reports of suspected suspected of having abused or neglected a child Local authority refers to two groups: 1) the social serv­ immediately if a report is considered an child abuse and neglect. Usually, this agency is a coun­ should be informed of his/her legal rights. ice agency (local agency) designated by the state emergency; otherwise, intervention should ty welfare department or a child protective services 2) The person responsible for the child's welfare department of social services (state department) and take place within seventy-two hours. unit within that department. Police or sheriffs depart­ should receive written notice and be adv.ised of authorized by state law to be responsible for local child 11) The intake services worker should ensure the ments may also be mandated agencies. (See also his/her legal rights when protective custody abuse and neglect prevention, identification, and treat­ family's right to privll,cy by making the assess­ STATE AUTHORITY and LOCAL AUTHORITY) authority is exercised. ment efforts, and 2) the community child protection ment process time-limited. 12) The treatment services worker should d~velop 3) A child who is alleged to be abused or neglected coordinating council (comm unity council). The stand­ MANDATED REPORTERS o,:\' M'!I\.NDATORY should have independent· legal reprt!sentation in ards on local authority, as specified in the National an individu!\lized treatment plan fe: each REPORTERS a child protection proceeding. Center on Child Abuse and Neglect Revision to family and each family member. Persons designated by state statutes who are legally lia­ 4) The parent or other person responsible for a Federal Standards on the Prevention and Treatment of 13) The treatment services worker should arrange ble for not reporting suspected cases of child abuse and child's welfare who is alleged to have abused or Child A buse and Neglect (Draft), include: for, coordinate, and monitor services provided neglect to the mandated agency. The persons so desig­ neglected a child should be entitled to legal to a famUy. nated vary according to state law, but they are pri­ representation in a civil or criminal proceeding. A dministration and Organization marily professionals, such as pediatricians, nurses, 5) The local child protective services unit should 1) The local agency should establish a distinct Resource Enhancement 14) The agency and the community council should. school personnel, and social workers, who have fre- 24 25

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r

quent contact with children and families. MENTAL INJURY Injury to the intellectual or psychological capacity of a MORAL NEGLECT (See CHILD ABUSE AND research, demonstration, and training programs and MARASMUS child as evidenced by observable and substantial im­ NEGLECT) provides technical assistance to state and local agencies A form of protein-calorie malnutrition occurring in in­ pairment in his/her ability to function within a normal with the goal of increasing and improving child welfare fants and children. It is characterized by retarded range of performance and behavior, with due regard to MORIBUND services. These services include in-home support to growth and progressive wasting away offat and muscle, his/her culture. The Child Abuse Prevention and Dying or near death .. families, such as parent education and homemaker but it is usually accompanied by the retention of ap­ Treatment Act and some state statutes includ.e mental services; foster care, adoption, and child protective petite and mental alertness. injury caused by a parent or caretaker as child abuse or MOTHERS ANONYMOUS services; and institutional care of children. A major neglect. Original name of Parents Anonymous. (See PARENTS project of NCCA is the Child Welfare Resource Infor­ MATERNAL CHARACTERISTICS' SCALE ANONYMOUS) mation Exchange. (See also CHILD WELFARE Instrument designed to study personality charac­ MESENTERY RESOURCE INFORMATION EXCHANGE) teristics of rural Appalachian mothers and the level of Membrane attaching various organs to the body wall. MULTIDISCIPLINARY TEAM care they were providing their children. The purpose of A group of professionals and possibly paraprofes­ NATIONAL CENTER FOR THE PREVENTION METABOLISM this scale is to sharpen caseworkers' perception of sionals representing a variety of disciplines who in­ AND TREATMENT OF CHILD ABUSE AND "apathetic-futile" or "impulse-ridden" mothers' per­ The sum of all physical and chemical processes which teract and coordinate their efforts to diagnose and treat NEGLECT maintain the life of an organism. sonality characteristics for evaluation, diagnosis, and specific cases of child abuse and neglect. A 1205 Oneida St. formulation of a treatment plan in cases of child METAPHWSIS multidisciplinary group which also addresses the Denver, Colorado 80220 neglect. Some authorities believe this scale has not been general problem of child abuse and neglect in a given This center, which is affiliated with the Department of adequately validated. Wider part of a long bone between the' end and the shaft. community is usually described as a community team, Pediatrics of the University of Colorado Medical and it will probably consist of several multidisciplinary School, was established in the fall of 1972 to provide MA TERNAL.INFANT BONDING (See BOND­ MINIMALL Y ACCEPTABLE ENVIRONMENT teams with different functions (see COMMUNITY more extensive and up-to-date education, research, and ING) The emotional climate and physical surroundings TEAM). Multidisciplinary teams may include, but are clinical material to professionals working in the area of necessary for children to grow physically, mentally, not limited to, medical, child care, and law enforce­ child abuse and neglect. The center's multidisciplinary MEDIAL socially, and emotionally. ment personnel, social workers, psychiatrists and/or staff has provided leadership in formulating the views Toward the middle or mid-line. psychologists. Their goal is to pool their respective that child abuse and neglect is symptomatic of troubled MINOR (See CHILD) skills in order to formulate accurate diagnoses and to family relationships; that treatment must consider the MEDICAID, TITLE 19 (See SOCIAL SECURITY MIRANDA RULE provide comprehensive coordinated treatment with needs of all family members; and that outreach to iso­ ACT) continuity and follow-up for both parent(s) and child lated, non-trusting families and the multidisciplinary Legal provision that a confession is inadmissible in any or children. Many multidisciplinary teams operate ac­ approach are necessary. Funded by the State of Col­ court proceeding if the suspect was not forewarned of cording to the Denver Model (see DENVER orado, the HEW Administration for Children, Youth MEDICAL MODEL his/her right to remain silent before the confession was Conceptualizing problems in terms of diagnosis and disclosed. (See also FIFTH AMENDMENT) MODEL). Multidisciplinary teams may also be re­ and Families, and ..private foundations, the center's ,treatment of illness. With respect to child abuse and ferred to as cross-disciplin'ary teams, interdisciplinary work includes education, consultation and technical neglect, the medical model assumes an identifiable and MISDEMEANOR teams, or SCAN team!l (see SCAN TEAM). However, assistance, demonstration programs for treatment, therefore treatable cause of the abuse and/or neglect A crime for which the punishment can be no more than the Child Abuse Prevention and Treatment Act uses program evaluation, and research. This center also and focuses on identification and treatment in a medi­ imprisonment for a year and/or a fine of $ I ,000. A the term "multidisciplinary team." serves as the HEW Region VIII Res.ource Center. calor other health setting. For child abuse and neglect, misdemeanor is distinguished from a felony, which is some advantages of the medical model are financial more serious, and an infraction, which is less serious. ,NATIONAL ASSOCIATION OF SOCIAL NA TIONAL CENTER ON CHILD ABUSE AND support by the hospital, clinic, medical community; ac­ IWORKERS (NASW) NEGLECT (NCCAN) cessibility of medical services to the abused or MODEL CHILD PROTECTION ACT 1425 H St., N.W. P.O. Box I 182 neglected child; involvement of the physicians; and Guide for development of state legislation concerning Washington, D.C. 20005 Washington, D.C. 20013 visibility and public acceptance. Possible disadvan­ child abuse and neglect and intended to enable legisla­ A national organization of professional social workers Office of the federal government located within the tages are overemphasis on physical abuse; tors to provide a comprehensive and workable law who are enrolled in or have completed baccalaureate, Children's Bureau of the Administration for Children, overemphasis on physical diagnosis to the detriment of which will aid in resolving the problem. A draft Model master's, or doctoral programs in social work educa­ Youth and Families (formerly the Office of Child total treatment; and isolation from other professional Child Protection A ct has been developed and is availa­ tion. Members must subscribe to the NASW Code of Development), which is part of the Office of Human and community resources. (Kempe) ble from the National Center on Child Abuse and Ethics, and NASW provides a policy for adjudication Development Services of H EW. Established in 1974 by Neglect. of grievances in order to protect members and promote the Child Abuse Prevention and Treatment Act, the MEDICAL NEGLECT (See CHILD ABUSE AND ethical practices. functions of NCCAN are to: NEGLECT) #I MONDALE ACT (See CHILD ABUSE PREVEN­ I) Compile, analyze, and publish an annual sum­ TION AND TREATMENT ACT) NATIONAL CENTER FOR CH!LD ADVOCACY mary of recent and current research on child (NCCA) abuse and neglect. MENKES KINKY HAIR SYNDROME , MONGOLIAN SPOTS P.O. Box 1182 2) Develop and maintain an information Rare, inherited disease resulting in brittle bones and, A type of birthmark that can appear anywhere on a Washington, D.C. 20013 clearinghouse on all programs showing promise eventually, death. It is found in infants and, because of child's body, most frequently on the lower back. These I1 The National Center for Child Advocacy is part of the of success for the prevention, identification, and the great number of fractures the child may exhibit, can I dark spots usually fade by age five. They can be r I Children's Bureau of the Administration for Children, treatment of child abuse and neglect. be mistaken for child abuse. , mistaken for bruises. Youth and Families within the Office of Human 3) Compile and publish training materials for per­ Development Services of HEW. NCCA supports sonnel who are engaged or intend ~o engage in i 26 ,. .~ 27 .~------r, ------

NEGLIGENCE PA BUDDY the prevention, identification, and treatment of 3) Provide a national focal point for advocacy to prevent child abuse. . Failure to act. May apply to a parent, as in child Term used by Parents Anonymous for a person who child abuse and neglect. 4) Facilitate 90mmunication about programs, neglect, or to a person who by state statute is mandated functions like a parent aide in relation to a Parents 4) Provide technical assistance to public and policy, and research related to child abuse pre­ to report child abuse and neglect but who fails to do so. Anonymous member. (See also PARENTS nonprofit private agencies and organizations to Negligence lawsuits arising from failure to report are ANONYMOUS and PARENT AIDE) assist them in planning, improving, developing, vention. increasing, and any failure to obey the statutes proves and carrying out programs and activities relat­ 5) Foster greater cooperation between existing and developing resources for child abuse prevention. negligence. Lawsuits claiming damages for negligence PARAPROFESSIONAL ing to the prevention, identification, and treat­ are civil proceedings. Volunteer or agency employee trained t~ a limited ex­ ment of child abuse and neglect. Activities of the committee include a national media ... tent in a particular profession. Since paraprofessionals 5) Conduct research into the causes of child abuse NETWORKING are usually close in age, race, nationality, religion, or and neglect, and into the prevention, identifica- campaign, publications, conference, research', and the establishment of state chapters of the committee. Formal or informal linkages of individuals, families, or lifestyle to the clientele, they often have a greater tion, and treatment thereof. . other groups with similar social, education, medical, or likelihood of developing a trusting relationship with a 6) Make a complete and full study and investiga­ other service needs with the public or private agencies, client than do some professionals. The role of the tion of the national incidence of child abuse and NA TlONAL REGISTER organizations, and/or individuals who can provide such paraprofessional in protective service work is usually neglect, including a determination of the extent Often confused with the National Study on Child services in their locale. Formal agreements are usually to provide outreach or nurturance and advocacy for the to which incidents of child abuse and neglect are Neglect and Abuse Reporting (National Clearinghouse), which compiles statistics on incidence written and spell out under what circumstances a par­ family, often as a case aide or parent aide. (See also increasing in number or severity. ticular agency, group, or individual will provide cer­ PARENT AIDE) 7) Award grants to states whose child abuse and of child abuse and neglect. A national register, which tain services. Informal agreements are apt to be verbal neglect legislation complies with federallegisla­ does not exist at this time, would operate in much the same way and with the same purposes as a state-level and relate to a particular family or case. PARENS PATRIAE tion. \ central register, but would collect reports of abuse and "The power of the sovereign." Refers to the state's NCCAN is authorized to establish grants and contracts neglect nationwide. Collecting reports on a national I NURTURANCE power to act for or on behalf of persons who cannot act with public and private agencies and organizations to scale would be highly problematic because of variance t Affectionate care and attention provided by a parent, in their own behalf; such as, minors, incompetents, or carry out the above activities. Grants and contracts in state reporting laws and definitions of abuse and parent substitute, or caretaker to promote the well­ some developmentally disabled. may also be used to establish demonstration programs neglect. (See also CENTRAL REGISTER and NA­ being of a child and encourage healthy emotional and and projects which, through training, consultation, TIONAL STUDY ON CHILD NEGLECT AND physical development. Nurturance may also be needed PARENT resource provision, or direct treatment, are designed to ABUSE REPORTING) by adults with inadequate parenting skills, or who were Person exercising the function of father and/or mother, prevent, identify, and treat child abuse and neglect. themselves abused or neglected as children, as a model including adoptive, foster, custodial, and surrogate (See also CHILD ABUSE PREVENTION AND NA TIONAL STUDY ON CHILD NEGLECT AND \ for developing more positive relationships with their parents as well as biological parents. TREATMENT ACT and REGIONAL RESOURCE ABUSE REPORTING own children and as a way of strengthening their own CENTER) ... Formerly the National Clearinghouse on Child Neglect \ sel f -esteem. PARENT AIDE and Abuse, the National Study is funded by the Na­ A paraprofessional, either paid or voluntary, who func­ tional Center on Child Abuse and Neglect, Children's I OCCIPITAL tions primarily as an advocate and surrogate parent for NATIONAL CLEARINGHOUSE ON CHILD Bureau, HEW and is being conducted by the Children's Referring to the back of the head. a family in which child abuse or neglect is suspected or NEGLECT AND ABUSE (NCCNA) (See NA­ Division of the American Humane Association. The has been confirmed. The Parent Aide particularly TIONAL STUDY ON CHILD NEGLECT AND study has been established to systematically collect OMISSION, ACTS OF serves the mother by providing positive reinforcement, ABUSE REPORTING) data from official state sources on the nature, inci­ Failure of a parent or caretaker to provide for a child's emotional support, and nurturance, and by providing dence , and characteristics of child abuse and neglect. I physical and/or emotional well-being. (See also or arranging transportation, babysitting, etc., as neces­ CHILD ABUSE AND NEGLECT) sary. Rather than serving as a homemaker, nutrition NATIONAL COMMITTEE FOR THE PREVEN· Participating states receive reports generated from their own data on a quarterly basis so t?at they can . aide, or nurse, the parent aide's function is more like a TION OF CHILD ABUSE monitor their own reporting mechanisms. At this time, OSSIFICA TION , friend to the family. Parent aides may also be referred III E. Wacker Drive about 40 states are submitting detailed incidence data Formation of bone. to as case aides, lay therapists, or visiting friends. Suite 510 to the study. It is hoped that the National Study will be Chicago, Illinois 60601 OSTEOGENESIS IMPERFECT A PARENT EFFECTIVENESS TRAINING (PET) The National Committee originated in Chicago in 1972 able to produce accurate data on the national incidence An inherited condition in which the bones are abnor­ An educational program developed by Dr. Thomas in response to increasing national incidence of dea~hs of child abuse and neglect. . mally brittle and subject to fractures, and which may be Gordon and presented in his book, Parent Effective­ due to child abuse. It was formed to help prevent child mistakenly diagnosed as the result of child abuse. ness Training (New York, Peter H. Wyden, Inc., abuse which was defined as including non-accidental NEEDS ASSESSMENT , . 1970). The program, taught by trained and certified injury, emotional abuse, neglect, sexual abuse, and ex- A formal or informal evaluation of what services are needed by abused and neglected children and their OUTREACH PET instructors, focuses on improving communication ploitation of children, at a time when most progra~s The process in which professionals, paraprofessionals, between parents and children by teaching listening focused on identification and treatment. The commit­ families within a specified geographical area or within another given population. and/or volunteers actively seek to identify cases of skills and verbal expression techniques to parents. The tee's goals are to: family strees and potential or actual child abuse and PET course has proven useful for parents who are moti­ neglect by making services known, accessible, and vated to change, who are able to give it a considerable I) Stimulate greater publ ic awareness of the NEGLECT (See CHILD ABUSE AND NEGLECT) unthreatening. Effective outreach providing early in­ amount of time, and who can afford the relatively high problem. tervention is important for the prevention of child tvition. For these and other reasons, PET has not 2) Encourage public involvement in prevention NEGLECTED CHILD (See INDICATORS OF CHILD ABUSE AND NEGLECT) abuse and neglect. proven particularly useful in child abuse and neglect and treatment. 28 29

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treatment, especially when used as the only mode of adults, society accords parents the right to cust~dy and treatment. PETITIONER defendant agrees to participate in rehabilitative serv­ supervision of their own children, including, among Person who files a petition. ~njuvenile and family court ices. In child abuse cases, this usually involves coopera­ others, parents' rights to make decisions about their PARENT AL STRESS SER VICES practice, a petitioner may be a probation officer, social tion with child protective services and/or voluntary children's health care. This plus parents' rights to pri­ Services aimed at relieving situational and/or worker; '(jr prosecutor, as variously defined by state treatment, such as Parents Anonymous. vacy may complicate investigations of suspected child laws. t. psychological parental stress in order to relieve family abuse and neglect and treatment of confirmed cases. dysfunction and to prevent parents from venting rage PREVENTION OF CHILD ABUSE AND Parents' rights may be cited in court in order to prevent or frustration on their children. Service usually begins i>HYSICAL ABUSE (See CHILD ABUSE AND NEGLECT the state from taking custody of a child who is in danger via a telephone helpline and may include home visits. NEGLECT) Elimination of the individual and societal causes of in his/her own home. (See also CHILDREN'S I child abuse and neglect. Workers are usually trained volunteers or paraprofes­ RIGHTS) . " t sionals who focus on providing warmth, nurturance, PHYSICAL NEGLECT (See CHILD ABUSE AND NEGLECT) Primary Prevent ion friendship, and resource referrals to the distressed PARENTS UNITED parent. Some parental stress services promote develop­ r.)' Providing societal and community policies and Organization name sometimes used for self-heip groups ment and use of Parents Anonymous chapters for their PLEA BARGAINING programs which strengthen all family functioning so of parents in families in which sexual abuse has occur­ clients. Parental Stress Services may refer to specific Settlement of a criminal prosecution, usually by the that child abuse and neglect is less likely to occur. red. Begun \n 1972, Parents United is one component reduction of the charge and/or the penalty, in return for programs such as in Chicago, lIIinois, or Oakland, of a model Child Sexual Abuse Treatment Program in California, although there is no organizational linkage I a plea of guilty. Plea bargains are sometimes justified Secondary Prevent ion Santa Clara County, California. (See also f by congested court calendars, They are attacked as Intervention in the early signs of chiM abuse and between them, or this may be a functional description DAUGHTERS UNITED) of services provided within a larger agency program. devices which weaken the intended effect of penal neglect for treatment of the presenting problem and statutes and which reduce the dignity of the criminal PASSIVE ABUSER to prevent further problems from developing. PARENTING SKILLS justice system. Far more than half of all criminal Parent or caretaker who does not intervene to prevent A parent's competencies in providing physical care, prosecutions in this country are resolved by plea Tertiary Prevention abuse by another person in the home. I bargaining. protection, supervision, and psychological nurturance Treatment after child abuse and neglect has been [ confirmed. appropriate to a child's age and stage of development. PATHOGNOMONiC Some parents, particularly those whose own p,arents POLICE HOLD (See CUSTODY) A sign or symptom specifically distinctive or charac­ f demonstrated these skills, have these compeiencies Primary, and to varying degrees secondary and terti­ teristic of a disease or condition from which a diagnosis I POLYPHAGIA ary, prevention requires: without formal training, but adequacy of these skills may be made. may be improved through instruction. Excessive or voracious eating. PERINATAL I) Breaking the tendency in the generational cycle PARENTS ANONYMOUS PREDICTION OF CHILD ABUSE AND wherein the abused or neglected child is likely to Around the time of birth, both immediately before and NEGLECT 22330 Hawthorne Blvd., #208 afterward. become the abusive or neglectful parent. Torrance, California 90505 There are no evaluation instruments or criteria to pre­ 2) Helping a parent cope with a child who has dict absolutely that child abuse or neglect will occur in Self-help group for parents who want to stop physical, PERIOSTEAL ELEVATION special problems or special meaning to a parent. psychological, sexual, or verbal abuse of their children. specific families. Recently, experts have developed in­ 3) Helping families cope with long term and im­ The ripping or tearing of the su,rface layer of a bone Because members do not need to reveal their full struments and methods of evaluating the bonding proc­ mediate situational or interpersonal stress. (periosteum) and the resultant hemorrhage, occuring ess at childbirth in order to identify families where 4) Linking families to personal and community names, they feel free to share concerns and provide when a bone is broken. mutual support. Members are accountable to the group because of i~complete or inadequate bo"nding, it can be sources of help to break their social isolation. expected that without further appropriate intervention, for their behavior toward their children, and the group PERITONITIS S) Eliminating or alleviating violence in our functions like a family in supporting members' efforts child abuse or neglect may occur. Besides bonding, society, particularly sanctioned violence such as Inflammation of the membrane lining the abdomen many other indicators can be used to identify families­ corporal punishment in the schools. to change. With chapters in every state, over 800 in all, (peritoneum); caused by infection. Parents Anonymous has been formally evaluated as an at-risk for child abuse and neglect, but these factors are A major problem in preventing child abuse and neglect rarely sufficiently conclusive to enable absolute predic­ effective method for treating child abuse. Unlike most PERJURY is the stigma attached to the problem and to receiving other self-help groups with anonymous members, tion. (See also BONDING and FAMILIES-AT -RISK) services from a county protective service agency. Intentionally inaccurate testimony. Perjury is usually Anonymous requires that each chapter have an Therefore, prevention programs must include com­ ~arents punishable as a felony, but only if the inaccuracy of the unpaid professional sponsor who attends all meetings PREPONDERANCE OF EVIDENCE (See EVI­ munity education and outreach. Another problem is testimony and the witness's knowledge of the inac­ DENTIARY STANDARDS) that stress is pervasive in our society, and ways must be to facilitate discussion, provide a role model, and sug­ curacy can be proven. gest appropriate community resources for members' found both to reduce it and deal with it if child abuse problems. The Child Abuse Prevention and Treatment PRESENTMENT and neglect is to be prevented. (See also EARLY IN­ PETECHIAE (See INTRADERMAL HEMOR­ The notice taken or report made by a grand jury of an TERVENTION) Act provides for funding of self-help groups, and RHAGE) Parents Anonymous is one of the few self-help offense on the basis of the jury's knowledge and without a bill of indictment. (See also INDICTMENT) PRIMA FACIE organizations which has received funding from the PETITION federal government. A latin term approximately meaning "at first sight," Document filed in juvenile or family court at the begin­ PRE·TRIAL DIVERSION "on the first appearance," or "on the face of it." In law, PARENTS' RIGHTS ning of a neglect, abuse, and/or delinquency case. The Decision of the district attorney not to issue charges in this term is used in the context of a "prima facie case." petition states the al.legations which, if true, form the a criminal case where those charges would be provable. That is, the presentation of evidence at a trial which has Besides the rights protected by the Constitution for all basis for court intervention. The decision is usually made on the condition that the been sufficiently strong to prove the allegations unless 30 31' -----,-,'- - ~------.-

mands of life. The term "psychotic" is neither very pre­ his/her own home, foster care, or adoption. contradicted and overcome by other evidence. In a, I) Comprehensive planning, including identifying cise nor~, definite. However, the parent who is child maltreatment case, the allegations of maltreat­ gaps and duplication in service and funding periodically psychotic or psychotic for extended RECIDIVISM ment will be considered as proven unless the parent. policies. periods and who abuses his/her children has a poor Recurrence of child abuse and neglect. This happens presents rebutting evidence. 2) Developing interagency referral poliCies. prognosis;' permanent removal of the children is often relatively frequently because child protective service 3) Educating members to new and/or effective ap- recommended in this situation. It is estimated that well agencies heretofore have been mandated and staffed PRIVILEGED COMMUNICATIONS proaches to child abuse and neglect. . under 10% of all abusive or neglectful parents are only to investigate and provide crisis intervention and Confidential communications which are protected by 4) Problem sharing. psychotic. not to provide treatment. Most cases where child abuse statutes and need not or cannot be disclosed in court 5) Facilitating resolution of interagency conflicts. or neglect results in a child's death have been pre­ over the objections of the holder of the privilege. 6) Providing a forum where differing professional PUBLIC' AWARENESS (See COMMUNITY viously known to a child protection agency. Lawyers are almost always able to refuse to disclose and agency expertise can be pooled ..• AWARENESS) what a client has told them in confidence. Priests are 7) Generating and lobbying for needed legislation. REFEREE (See HEARING OFFICER) similarly covered. Doctors and psychotherapists have (See also COMMUNITY TEAM) PUBLIC DEFENDER generally lesser privileges, and their testimony can be Person paid with public funds to plead the cause of an REGIONAL RESOURCE CENTER compelled in many cases involving child abuse or PROTECTIVE CUSTODY (See CUSTODY) indigent defendant. With respect to child abuse and neglect, a regional neglect. Some social workers are covered by such resource center was funded as a demonstration project statutes, but the law and practice vary widely from state PROTOCOL PUBLIC LAW 93-247 (See CHILD ABUSE PRE­ in each of the ten HEW regions under the 1974 Child to state. (See also CONFIDENTIALITY) A set of rules or guidelines prescribing procedures and VENTION AND TREATMENT ACT) Abuse Prevention and Treatment Act. These resource responsibilities. Originally used primarily in medical centers vary in program emphasis, but they all function PROBABLE CAUSE settings, establishment of protocols is an increasingly PUNISHMENT to some degree as extensions of the National Center on A legal standard used in a number of contexts which in­ important goal of the child abuse and neglect com­ Infliction of pain, loss, or suffering on a child because Child Abuse and Neglect in Washington to help NC­ dicates a reasonable ground for suspicion or belief in munity team. the child has disobeyed or otherwise antagonized a CAN fulfill the aims of the Child Abuse Prevention and the existence of certain facts. Facts accepted as true parent or caretaker. Abusive parents may inflect Treatment Act (see NATIONAL CENTER ON after a reasonable inquiry which would induce a pru­ PROXIMAL punishment without cause, or may inflict punishment, CHILD ABUSE AND NEGLECT and CHILD dent and cautious person to believe them. Also-Please Near; closer to any point of reference; opposed to particularly corporal punishment, in the belief that it is ABUSE PREVENTION AND TREATMENT ACT). note that the definitions on page 28 of EVIDENTI­ distal. the only way to discipline children. Many parents con­ Besides regional centers, there are also state resource AR Y STANDARDS are incorrect. A suggested alter­ fuse the difference between discipline and punishment. centers in Arizona, Maryland, New York, and North native follows: PSYCHOLOGICAL ABUSE (See CHILD ABUSE These differences are delineated under DISCIPLINE. Carolina; and two national resource centers, operated AND NEGLECT) (See also CORPORAL PUNISHMENT), by the Education Commission of the States and the Na­ PROBATE COURT (See COURTS) tional Urban League. The regional resource centers PSYCHOLOGICAL NEGLECT (See CHILD PURCHASE OF SERVICE are: PROBATION ABUSE AND NEGLECT) . Provision for diagnosis and/or treatment of child abuse Allowing a convicted criminal defendant or a juvenile and neglect by an agency other than the mandated Region I (Connecticut, Maine, Massachusetts, New agency using mandated agency funds. The mandated found to be delinquent to remain at liberty, under a PSYCHOLOGICAL PARENT Hampshire, Rhode Island, Vermont) suspencted sentence of imprisonment, generally under agency subcontracts with the provider agency for Judge Baker Guidance Center Adult who, on a continuing day-to-day basis, fulfills a specific services with specific clients, but the mandated the supervision of a probation officer and under certain child's emotional needs for nurturance through interac­ 295 Longwood Ave. conditions. Violation of a condition is grounds for agency retains statutory responsibility for the case. (See Boston, Massachusetts 02115 tion, companionship, and mutuality. May be the also CASE MANAGEMENT) revocation of the probation. In a case of child abuse or natural parent or another person who fulfills these Region II (New Jersey, Puerto Rico, Virgin Islands) neglect, a parent (lr caretaker who is convicted of the functions. College of Human Ecology Cornell University offense may be required, as part of his/her probation, to PURPURA (See INTRADERMAL HEMOR­ RHAGE) MVR Hall make certain promises to. undergo treatment and/or to PSYCHOLOGICAL TESTS Ithaca, New York 14853 improve the home situation. These promises are made Instruments of various types used to measure ,emo­ Region III (Pennsylvania, Virginia, Delaware, West as a condition of the probation in which the child is RADIOLUCENT tional, intellectual, and personality characteristics. Virginia, District of Columbia) returned home and are enforced with the threat of Permitting the passage of X-rays without leaving a Psychological tests should always be administered and Institute for Urban Affairs and Research revocation of parental rights. shadow on the film. Soft tissues are radiolucent; bones interpretated by qualified personnel. Such tests have are not. Howard University been used to determine potential for abuse or neglect, 2900 Van Ness St., N.W . PROGRAM COORDINATION . effects of abuse or neglect, or psychological makeup of RAREFACTION Washington, D.C. 20008 Interagency of intra-agency communication for policy, parent or children. Loss of density. On an X-ray photograph, an area of Region IV (Alabama, Florida, Georgia, Kentucky, program, and resource development for an effectiv: bone which appears lighter than normal is in a state of Mississippi, South Carolina, Tennessee) service delivery system in a given locality. Program PSYCHOTIC PARENT rarefaction, indicating a loss of calcium. Regional Institute of Social Welfare Research coordination for child abuse and neglect is usually im­ A parent who suffers a major mental disorder where the P.O. Box 152 plemented through a community council or community individual's ability to think, respond emotionally, RECEIVING HOME Heritage Building task force or planning committee under the direction of remember, communicate, interpret reality, or behave A family or group home for temporary placement of a 468 N. Milledge Ave. a program coordinator. The functions of thes.e groups appropriately is sufficiently impaired so as to interfere child pending more permanent plans such as return to Athens, Georgia 30601 are: grossly with his/her capacity to meet the ordinary de- 33 32

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, . REPORTING LAWS Region V (Illinois, Indiana, Michigan, Minnesota, MULTIDISCIPLINARY TEAM and DENVER SEQUELAE State laws which require, specified categories of per­ Ohio, Wisconsin) • MODEL) After-effects; usually medical events following an inj­ Midwest Parent-Child Welfare Resource Center sons, such as professionals involved with children, and ury or disease. In child abuse and neglect, sequelae is Center for Advanced Studies in Human Services allow other persons, to notify public autliorities of SCAPEGOATING used to refer to psychological consequences of abusive cases of suspected child abuse and, sometimes;neglect. School of Social Welfare Casting blame for a problem on .one who is innocent or acts an'd also the perpetuation of maltreatment All 50 states now have reporting statutes; but they University of Wisconsin-Milwaukee only partially responsible; for example, a parent or behavior across generations, as well as specific after­ differ widely with respect to types of instances' wh ich Milwaukee, Wisconsin 53201 caretaker' abusing or neglecting a child as punishment effects such as brain damage, speech impairment, and Region VI (Arkansas, Louisiana, New Mexico, must be reported, persons who must report, time limits for family problems unrelated to the child. impaired physical and/or psychological growth. Oklahoma, Texas) for reporting, manner of reporting (written, oral, or Center for Social Work Research both), agencies to which reports must be made, and the SERVICES School of Social Work degree of immunity conferred upon reporter~.: SCURVY Condition caused by a deficiency of vitamin C (ascor­ (See EARLY INTERVENTION, EMERGENCY University ,of Texas at Austin I· SER VICES, PREVENTION OF CHILD ABUSE Austin, Texas 78712 RES IPSA LOQUITOR bic acid) and characterized by weakness, anemia, I spongy gums, and other symptoms. ' AND NEGLECT, SUPPORTIVE SERVICES, Region VII (Iowa, Kansas, Missouri, Nebraska) Latin expression meaning "the thing speaks for itself." TREATMENT OF CHILD ABUSE AND Institute of Child Behavior and Development It is a doctrine of law which, when applied to criminal [ NEGLECT) University of Iowa law, means that evidence can be admitted which is ac­ SEALING In juvenile court or criminal court practice, the closing Oakdale, Iowa 53219 ceptable despite the fact that no one actually saw what SEXUAL ABUSE Region VIII (Colorado, Montana, North Dakota, of records to inspection by all but the defendant or occurred, only the results. An example in criminal law In order to encompass all forms of child sexual abuse South Dakota, Utah, Wyoming) minor involved. Sealing is provided by statute in some would be admitting into evidence in a child abuse case and exploitation within its mandate, the National I states and may be done after proof is made that the de­ National Cetlter for the Prevention and Treatment the medical reports of the irijured child victim which Center on Child Abuse and Neglect has adopted the of Child Abuse and Neglect fendant or minor has behaved lawfully for a specified reflect multiple broken bones and the doctor's opinion following tentative definition of child sexual abuse: University of Colorado Medi~al Center t period of years. Note that juvenile court records are that said injuries could not have been caused by an ac­ r contacts or interactions between a child and an ad ul t 1205 Oneida St. never public, as are the records of most other courts; cident. The court using the res ipsa [oquilor doctrine when the child is being used for the sexual stimula­ Denver, Colorado 80220 access to juvenile court records is theoretically very can convict the, person having had exclusive custody of tion of the perpetrator or another person. Sexual Region IX (California, Hawaii, Nevada, Guam, restricted, even before sealing. (See also EXPUNGE­ the child without any direct testimony as to how, when, abuse may also be committed by a person under the Trust Territories of the Pacific, American Samoa) MENT) where, or why the injuries were inflicted. age of 18 when that person is either significantly Department of Special Education older than the victim or when the perpetrator is in a California State University RETINA SEIZURES position of power or control over another child. (See 5151 State University Dr. Inside lining of the eye. Injury to the head can cause Uncontrollable muscular contractions, usually alter­ Los Angeles, California 90033 also CHILD ABUSE AND NEGLECT) bleeding or·detachment of the retina, possible causing nating with muscular relaxation and generally accom­ Region X (Alaska, Idaho, Oregon, Washington) blindness. panied by unconsciousness. Seizures, which vary in in­ SEXUAL ASSAULT Northwest Federation for Human Services tensity and length of occurrence, are the result of some Unlawful actions of a sexual nature committed against 157 Yesler Way, #208 RICKETS brain irritation which has been caused by disease, in­ a person forcibly and against his/her own will. Various Seattle, Washington 98104 Condition caused by a deficiency of vitamin D, which herited condition, fever, tumor, vitamin deficiency, or degrees of sexual assault are established by state law disturbs the normal development of bones. injury to the head. REGISTRY (See CENTRAL REGISTER and NA­ and are distinguished by the sex of the perpetrator TIONAL REGISTER) and/or victim, the amount of force used, the amount ROLE REVERSAL SELF·HELP GROUP and type of sexual contact, etc. Sexual abuse is one REHEARING The process whereby a parent or caretaker seeks nur­ Groups of persons with similar, often stigmatized, form of sexual assault wherein the perpetrator is known After a juvenile court referee or commissioner has turance and/or prot~ction from a child rather than pro­ problems who share concerns and experiences in an by the victim and is usually a member of the family. heard a case and made an order, some states perm it a viding this for the child, who frequently complies with effort to provide mutual help to one another. Usually (See also CHILD ABUSE AND NEGLECT) dissatisfied party to request another hearing before the this reversal. Usually this process develops as a result these groups are self-directed. (See also PARENTS supervising judge of juvenile court. This second hear­ of unfulfilled needs of the parent or caretaker. ANONYMOUS) SEXUAL EXPLOIT A TION ing is called a rehearing. If the original hearing was not A term usually used in reference to sexual abuse of recorded by a court reporter, the rehearing may have to SACRAL AREA SELF·INCRIMINA TION children for commercial purposes; such as child be granted. If a transcript exists, the judge may read it Lower part of the back. The giving of a statement, in court or during an in­ prostitution, sexual exhibition, or the production of and either grant or deny the rehearing. vestigation, which subjects the person giving the state­ pornographic materials. (See also CHILD POR­ SCAN TEAM ment to criminal liability. (See also DUE PROCESS, NOGRAPHY, CHILD PROSTITUTION) REPARENTING Suspected Chiid Abuse and Neglect team which has as FIFTH AMENDMENT, IMMUNITY, and MIRAN­ Usually describes a nurturing process whereby parents its objective the assessment ofa child and his/her family DA RULE) SEXUAL MISUSE who have not received adequate nurturance during_ to determine if abuse and/or neglect has occurred and Alternative term for sexual abuse, but particularly their own childhoods are provided with emotional what treatment is indicated. The team usuall) includes SENTENCING reflects the point of view that sexual encounters with warmth and security through a surrogate parent such as a pediatrician, a social worker, and a psychiatrist or The last stage of criminal prosecution in which a con­ children, if properly handled, need not be as harmful as a parent aide. Abusive and neglectful parents are thus psychologist, but other professionals are often involved victed defendant is ordered imprisoned, fined, or is usually assumed. Its implication is that children are given an opportunity to identify with more positive role as well. A SCAN team or unit is generally located in a granted probation. This is equivalent in a criminal case not necessarily harmed by so-called sexually abusive models. hospital or outpatient facility. (See also to the disposition in a juvenile court case. acts themselves, but rather the abuse results from

34 35 n~ . damage generated by negative social and cultural reac­ Title IV-Parts A, B, C, D (A id to Families, with funding to support the well-being of all families and STANDARD OF PROOF (See EVIDENTIARY tions to such acts. (See also CHILD MISUSE AND Dependent Children, Child Welfare Service~, Work '\ children -dr to provide sufficient resources to prevent STANDARDS) NEGLECT, INCEST, SEXUAL ABUSE) Incentive Program, Child Support and Establish- and treat' 'child abuse and neglect, particularly for ment of Paternity) ; j minority populations such as migrant workers and Na­ STANDARDS SEXUALLY TRANSMISSIBLE DISEASE Part A, now included under Title XX as services for (STD) (See VENEREAL DISEASE) tive Americans. Guides developed to ensure comprehensiveness and children, was designed to encourage famiHe$ to care ,o;!J adequacy of programs or services. Issued by relevant for dependent children in their own or relatives' SPECIAL' CHILD agencies, such as the National Center on Child Abuse SIMPLE FRACTURE (See FRACTURE) homes by providing services to families below a I~ A child who is abused or neglected or at risk of abuse and Neglect for state and local level programs and the specified income level. As a condition of ;re~eiving [1 or neglect because he/she has a special problem with Child Welfare League of America for member agen­ SITUATIONAL CHILD ABUSE AND NEGLECT federal funding for this program, states mu,s! provide ~ I which the 'parent(s) have difficulty coping or because cies, standards have various levels of authority. Refers to cases of child abuse and particularly child family planning services. Part B authorizes support the child. has some psychologically negative meaning neglect where the major causative factors cannot be to states for child welfare services developed in for thepilrent. Also referred to as "target child." If this STATE AUTHORITY readily eliminated because they relate to problems over coordination with the AFDC program to supple­ fr child is abused, the cause may be referred'to as "vic­ State authority refers to the state department of social which the parents have little control. (See also APA­ ment or substitute for parental care and supervision. tim" precipitated abuse." services (state department) and a state child protection THY-FUTILITY SYNDROME) These services include day care, foster care, and r J coordinating committee (state committee). As desig­ other preventive or protective programs promoting if nated in state law, these structures are to accept respon­ SKELETAL SURVEY child and family welfare. Part C offers job training SPIRAL FRACTURE (See FRACTURE) J sibility for child abuse and neglect prevention, iden­ A series of X-rays that studies all bones of the body. and placement for AFDC parents in an effort to , tification, and treatment efforts. The standards on state Such a survey should be done in all cases of suspected assist them in becoming self-supporting. Part 0 en­ r SPOUSE ABUSE , authority, as specified in the National Center on Child abuse to locate any old, as well as new, fractures which forces the support obligations owed by absent Non-acciden'tal physical or psychological lOJury in­ Abuse and Neglect Revision to Federal Standards on the may exist. parents to their children by locating absent parents, flicted on either husband or wife by his/her marital I partner. Some experts conjecture that husbands as well Prevention and Treatment of Child Abuse and Neglect establishing paternity, and obtaining child support. SOCIAL ASSESSMENT (See ASSESSMENT) as wives are frequently abused, particularly (Draft), include: Administratioll and Organization Title V-Maternal and Child Health and Applied psychologically, but the subject of husband abuse has SOCIAL HJSTOR Y Children's Services I not gained public or professional recognition to the ex­ 1) The state department should establish child abuse and neglect policies that are consistent 1) Information compiled by a social worker about Provides a broad range of health care services for tent that battered wives has. Domestic violence 'is the f with the state law and conducive to state-wide factors affecting a family's past and present level of mothers and children from low-income families in term used when referring to abuse between adult mates delivery of uniform and coordinated services. functioning for use in diagnosing child abuse and order to reduce maternal and infant mortality and to who may not be married. (See also BATTERED \ 2) The state department should establish a dis­ neglect and developing a treatment plan. prevent illness. WOMEN) 2) Document prepared by a probation officer or tinct child protection division (state division) social worker for the juvenile or family court hear­ Title XIX-Grants to States for Medical Assis­ ST AFF BURNOUT to facilitate the implementation of departmen­ ing officer's consideration at the time of disposition tance Programs (Medicaid or Title /9) \1 Apathy and fru'stration felt by protective service tal policies. 3) The state department should designate child of a case. This report addresses the minor's history Designed to help families with dependent children workers who are overworked, undertrained, and lack­ and environment. Social histories often contain and -other low-income persons by providing finan­ ing agency or supervisory support. This is a common protective services units (local units) within each regional and/or local social services agen­ material which would clearly be inadmissible in cial assistance for necessary medical services. This problem, and workers who do not leave protective most judicial proceedings, either because of hear­ act is additionally designed to provide rehabilitation services (see STAFF FLIGHT) or who do not have cy. 4) The state committee, as required by state law, say or lack of verification or reliability. The infor­ and other psychotherapy services to help families supervisory support often lose sensitivity to client should be representative of those persons and mal use of such reports has often been attacked as and individuals retain or regain independence and needs. (Also referred to as Worker Burnout) in violation of due process rights of minors and sel f-sufficiency. agencies concerned with child abuse and parents. neglect prevention, identification, and treat- ST AFF FLIGHT ment. Title XX-Grants to States for Services -- -I· SOCIAL REPORT (See SOCIAL HISTOR Y) Provides grants to states for developing programs Continous change of child protective services staff due Primary Preven tion and services designed to achieve the following goals to staff burnout (see STAFF BURNOUT). This creates 5) The state division and the state committee SOCIAL ISOLATION for families and/or children: economic self-support; the need to provide frequent training for new workers. should work together towards primary preven­ The limited interaction and contact of many abusive self-sufficiency; prevention of abuse and neglect; Informed estimates place the overall national turnover tion of child abuse and neglect through for­ and/or neglectful parents with relatives, neighbors, preserving; rehabilitating, reuniting families; refer­ rate of protective service workers at 85% annually. malized needs assessment and planning proc­ friends, or community resources, Social isolation can ring for institutional care when other services are not esses. Secondary and Tertiary Prevention perpetuate a basic lack of trust whi~h hinders both appropriate. STAFF SATISFACTION identification and treatment of child abuse and neglect. Structuring a supportive and encouraging environment 6) The state division and the st'ate committee should jointly develop a comprehensive and Mandated child protective service agency programs for protective service workers with regular periods coordinated plan for delivery of services to SOCIAL SECURITY ACT are primarily funded through Title IV -B and Title XX when no new cases are assigned, thereby decreasing high-risk children and families, Established in 1935 as a national social insurance of the Social Security Act. staff burnout and staff flight. Supervisors and ad­ program, this federal legislation includes several sec­ ministrators need to develop programs including the 7) The state division should ensure that those per­ sons who have reason to suspect child abuse or tions particularly applicable to child and family SOCIETAL CHILD ABUSE AND NEGLECT following elements: manageable caseloads, in-service neglect can make a report at any time, twenty­ welfare: Failure of society to provide social policies and/or training, participation in and responsibility for agency decision-making. four hours a day, seven days a week. 36 37

'. I

______...... - ______~ ____Lo. ______~ __~~ ______~ ______~- ---.. ,~----"'r"-~ ------[I ; 1

8) The state division should transmit reports to confusion resulting from the Women's Movement, and and procedures. Unlike many practitioners in law SYPHILIS (See VENEREAL DISEASE) appropriate authority for assessment of the unresolved psychodynamic conflicts from childhood. and medicine, social workers do not generally degree of risk to the child. practice independently or make totally indepen­ TARGET CHILD (See SPECIAL CHILD) 9) The state division should operate a central SUBDURAL HEMATOMA dent judgments. In general, social work supervisors registry that facilitates state and local plan- A common symptom of abused children, consisting ofa hold Master's degrees, but in some local public TEMPORAL ning. collection of blood beneath the outermosttn'embrane agencies these supervisors may be just out of gradu­ Referring to the side of the head. 10) The state division's operation of the central covering the brain and spinal cord. The hematoma may ate school and have little experience. Since good registry should ensure that children and be caused by a blow to the head or from shaking a baby supervision is a critical factor in reducing the TEMPORARY CUSTODY (See CUSTODY) families' rights to prompt and effective services or small child. (See also WHIPLASH-SHAKEN IN­ problem of staff burnout and staff flight, it IS im­ are protected. FANT SYNDROME) portant for child protective service agencies to pro­ TEMPORARY PLACEMENT Resource Enhancement ~. vide training and continuing education oppor­ Voluntary or involuntary short term removal of a child tunities for supervisors. 11) The state division should develop and provide SUBPOENA f from his/her own home, primarily when a child's safety public and professional education. A document issued by a court clerk, usually delivered or well-being is threatened or endangered, or when a t SUPPORTIVE SERVICES 12) The state division should ensure that training is by a process server or police officer to the person su~­ family crisis can be averted by such action. Temporary provided to all divisional, regional, and local poenaed, requiring that person to appear at a certam Supportive services are a wide range of human services placement may be in a relative's home, receiving home staff. court at a certain day and time to give testimony in a r which provide assistance to families or individuals so or shelter, foster home, or institution. Temporary 13) The state division should conduct and/or spon­ specified case. Failure to obey a subpoena is punishable; that they are more nearly able to fulfill their potential placement should be considered only if service to the sor research, demonstration, and evaluation as contempt of court. for positive growth and behavior. The concept implies child and family within the home, such as use of a projects. that individuals have basic strengths which need to be homemaker or day care, is deter. 'ined to be insuffi­ (See also LOCAL AUTHORITY) SUBPOENA DUCES TECUM recognized, encouraged, and aided. Thus, a wide range cient to protect or provide for the child or if it is A subpoena requiring the person subpoenaed to bring \ of financial, educational, vocational, child care, coun­ unavailable. If the home situation does not improve STA TUS OFFENSE specified records to court. f seling, recreational, and other services might be seen as while the child is in temporary placement, long term supportive if they do indeed emphasize the strengths of An act which is considered criminal only because it is I placement may be warranted. However, authorities committed by a person of a particular status, such as a SUDDEN INI)'ANT DEATH SYNDROME (SIDS) people and de-emphasize their occasional needs for agree that too many temporary placements un­ minor. If an adult did the same thing, it would not be A condition which can be confused with child abuse, \ help in overcoming destructive and debilitating factors necessarily become permanent placements. (See also an offense. For example, a minor staying out after SIDS affects infants from two weeks to two years old, which may affect their lives. CUSTODY) curfew. but usually occurs in a child less than six months of age. SURROGA TE PARENT In SIDS a child who has been healthy except for a TERMINATION OF PARENTAL RIGHTS (TPR) STIPULA TION minor r:spiratory infection is found dead, often with A person other than a biological parent who, living A legal proceeding freeing a child from his/her parents' A statement, either oral or written, between lawyers on bloody frothy material in his/her mouth. The cause of within or outside the target home, provides nurturance. claims so that the child can be adopted by others both sides of a particular court case which establishes SIDS is not fully understood. The confusion with child This person may be self-selected or assigned to fulfill without the parents' written consent. The legal bases for parental functions. A surrogate parent may nurture certain facts about the case that are agreed upon by abuse results from the bloody sputum and occasional termination differ from state to state, but most statutes children or abusive or neglectful parents who were both sides. The facts delineated usually involve such facial bruises that accompany the syndrome. However, include abandonment as a ground for TPR. (See also issues as the addresses of the persons involved in the SIDS parents rarely display the guarded or defensive themselves abused as children and therefore are in need ABANDONMENT) case, their relationships to one another, etc. behavior that many abusive parents do. of a nurturing parental model. (See also PARENT AIDE) TESTIMONY STRESS FACTORS SUMMONS A declaration or statement made to establish a fact, Environmental and/or psychological pressures over a A document issued by a court clerk, usually delivered SUSPECTED CHILD ABUSE AND NEGLECT especially one made under oath in court. prolonged period which are associated with child abuse by a process server or police officer to the person sum­ Reason to believe that child abuse or neglect has or is and neglect or which, without being prolonged, may be moned, notifying that person of the filing of a lawsuit occurring in a given family. Anyone can in good faith THREA TENED HARM report this to the local mandated agency, which will in­ the precipitant event. While a certain amount of s~re~s against him/her and notifying that person of the Substantial risk of harm to a child, including physical vestigate and protect the child as necessary. However, can be useful in motivating people to change, It IS deadline for answering the suit. A summons does not or mental injury, sexual assault, neglect of physical all states have statutes which provide that members of generally agreed that there is an overload of stress in require the attendance at court of any person. and/or educational needs, inadequate supervision, or our present society, perhaps because people feel certain professions must report and that failure to do so abandonment. decreasingly in control of the forces affecting their SUPER VISION is punishable by fine or imprisonment. For specific cri­ teria for suspecting child abuse or neglect, see IN­ lives. Prevention of child abuse and neglect requires 1) Provision of age-appropriate protection and gui­ TITLE IV (See SOCIAL SECURITY ACT) both reducing stress in society and helping people cope dance for a child by a parent or caretaker. This is a DICATORS OF CHILD ABUSE AND NEGLECT and FAMILIES-AT -RISK. with it. Environmental stress which may influence child parental responsibility, but in some cases of child TITLE V (See SOCIAL SECURITY ACT) abuse and neglect includes, but is not limited to, abuse and neglect or for other reasons, the state ,I SUTURE unemployment, poverty, poor and overcrowded hous­ may have to assume responsibility for supervision. TITLE XIX (TITLE 19, MEDICAID) (See ing, competition for success, and "keeping up with the (See also CHILD IN NEED OF SUPER VISION) I) A type of immovable joint in which the connecting SOCIAL SECURITY ACT) Joneses." Psychological stress besides that caused by 2) Process in social work practice whereby workers surfaces of the bones are closely united, as in the skull. environmental factors which may influence child abuse review cases with supervisors to assure case TITLE X;X (See SOCIAL SECURITY ACT) and neglect could include such problems as marital progress, to sharpen' the workers' knowledg~ and 2) The stitches made by a physician that close a wound. discord, in-law problems, unwanted pregnancy, role skill, and to assure maintenance of agency policies TORUS FRACTURE (See FRACTURE)

38 39 ~-~--.------~~ ~------...-, --~ - --~-

be given "reasonable cause to believe" that a crime has TRABECULA suspected cases and crisis intervention, long term treat­ VERIFICA TION OF CHILD ABUSE AND NEGLECT occurred and that the warrant is necessary in the ap­ A general term for a supporting or anchoring strand~ of ment is best assured through use of a community team prehension and conviction of the criminal. tissue. (see COMMUNITY TEAM). Substantiation of child abuse or neglect following in­ vestigation of suspected cases by mandated agency TRAUMA Both crisis intervention and long term treatment will workers and/or assessment by a diagnostic team. Also WHIPLASH-SHAKEN INFANT SYNDROME An internal or external injury or wound brought about usually require a mix of supportive and therapeutic referred to as a founded report. Injury to an infant or child that results from that child by an outside force. Usually trauma means injury by services. Supportive services could include having been shaken, usually as a misguided means of violence, but it may also apply to the wound caused by homemakers, day care, foster grandparents, parent VICTIM-PRECIPIT A TED ABUSE (See SPECIAL discipline. The most common symptoms, which can be any surgical procedure. Trauma may be caused acci­ education, health care, family planning, recreational CHILD) inflicted by seemingly harmless shakings, are bleeding dentally or, as in a case of physical abuse, non-accjden­ activities, housing assistance, transportation, legal and/or detached retinas and other bleeding inside the tally. Trauma is also a term applied to psychological services; employment training and placement, financial VISITING FRIEND (See PARENT AIDE) head. Repeated instances of shaking and resultant inj­ discomfort or symptoms resulting from an emotional counseling and assistance. Therapeutic services could uries may eventually cause mental and developmental shock or painful experience. include psychotherapy, casework, lay therapy from VITAL SIGNS disabilities. (See also SUBDURAL HEMATOMA) parent aides, group therapy, family or couple therapy, Signs manifesting life, such as respiratory rate, heartbeat, pulse, blood pressure, and eye responses. TRAUMA X and self-help such as Parents Anonymous. WILLFUL Designation -used by some hospitals for a child abuse Done with understanding of the act and the intention VOIR DIRE ~nd neglect program. TURGOR that the act and its natural consequences should occur. I) Procedure during which lawyers question prospec­ Condition of being swollen and congested. This can Some conduct becomes unlawful! or negligent only tive jurors to determine their biases, if any. TREA TMENT FOSTER CARE refer to normal or other fullness. when it is done willfully. Foster care for children with diagnosed emotional 2) Procedure in which lawyers question expert wit­ and/or behavioral problems in which foster parents TWENTY-FOUR HOUR EMERGENCY SERV­ nesses regarding their qualifications before the ex­ perts are permitted to give opinion testimony. WITNESS with special training and experience become part of a ICES I) A person who has seen or heard something. treatment team working with a particular child. Treat­ Local services available at all times to receive reports VOLUNTARY PLACEMENT 2) A person who is called upon to testify in a court ment foster care may be indicated for abused or and make immediate investigations of suspected cases hearing. severely neglected children. of child abuse and severe neglect and to perform crisis Act of a parent in which custody of his/her child is intervention if necessary. The mode of providing twen­ relinquished without a formal court proceeding. WORKER BURNOUT (See Staff Burnout) TREATMENT OF CHILD ABUSE AND ty-four hour emergency services varies in different Sometimes called voluntary relinquishment. NEGLECT localities. However, often mandated agency protective I) Helping parents or caretakers stop child abuse and service workers are on call for specific evening and VOLUNTEER ROLES WORK-UP neglect and assisting them and their children to func­ weekend assignments. Often the after-hours number I) Extension and enrichment of direct services to Study of a patient, often in a hospital, in order to pro­ tion adequately as a family unit. 2) Providing tempor­ rings the police or sheriffs department which then con­ families by unpaid, screened, trained, and supervised vide information for diagnosis. A full work-up includes ary placement and services as necessary for abused or tacts the assigned worker. (See also COMPREHEN­ persons who generally lack professional training. Com­ past medical and family histories, present condition neglected children until their parents can assume their SIVE EMERGENCY SERVICES) mon roles are parent aides, child care workers, and symptoms, laboratory, and, possibly, X-ray parental responsibilities without threat to the children's outreach workers, or staff for helplines. 2) Develop­ studies. welfare. 3) Terminating parental rights and placing the UNFOUNDED REPORT ment and advocacy of child abuse and negrect children in an adoptive home if the parents abandon Any report of suspected child abuse or neglect made to programs by unpaid persons through participation on WORLD OF ABNORMAL REARING (WAR) the children or absolutely cannot be helped. Experts the mandated agency for which it is determined that community councils, agency boards, or community A generational cycle of development in which abused believe that 80% to 85% of abusive and neglectful there is no probable cause to believe that abuse or committees. Scarce resources in relation to the mag­ or neglected children tend to grow up-to be abusive or parents can be helped to function without threat to neglect has occurred. Mandated agencies mayor may nitude of the problem of child abuse and neglect de­ neglectful parents unless intervention occurs to break their children's welfare and, more often than not, not remove unfounded reports from their records after mands that volunteers be used increasingly. the cycle. The diagram which follows outlines the without temporary placement of the children if suffi­ a period of time. (See also EXPUNGEMENT) WAR cycle. (Helfer) cient supportive services are available. WANTON XaRAYS VASCULAR Extremely reckless or malicious. Often used in court Photographs made by means of X-rays. X-rays are one Treatment for child abuse and neglect should include Of the blood vessels. proceedings in conjunction with "willful" to establish of the most important tools available to physicians in treatment for the abused and neglected children as well certain kinds of unlawful behavior only vaguely the diagnosis of physical child abuse or battering. With as for the parents. VENEREAL DISEASE distinguished from careless but lawful conduct. X-rays, or radiologic examinations, physicians can ob­ Any disease transmitted by sexual contact. The two serve not only the current bone injuries of a child, but Treatment for child abuse and neglect includes both most common forms of venereal disease are gonorrhea WARRANT Document issued by a judge, authorizing the arrest or also any past injuries that may exist in various stages of crisis inter~ention and long term treatment. The man­ and syphilis. Presence of a venereal disease in a child healing. This historical information contributes signifi­ dated agency may provide services directly or by may indicate that the mother was infected with the detention of a person or the search of a place and cantly to the assessment of a suspected case of child purchase of service from other agencies. Since a disease during the pregnancy, or it may be evidence of seizure of specified items in that place. Although a abuse. Radiologic examination is also essential to multiplicity of services is often necessary, a case sexual abuse. judge need not hold a hearing before issuing a warrant distinguish organic diseases that may cause bone management approach to treatment is usually most and although the party to be arrested or whose property breakage from physical child abuse. effective (see CASE MANAGEMENT). Because man­ VERBAL ABUSE (See CHILD ABUSE AND will be seized need not be notified, the judge must still dated agencies necessarily focus on investigation of NEGLECT) 40 41 ------.-,.--

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WA.RCYCLE References

Material for this GLOSSARY was obtained from the Hinsie, Leland, and Robert Campbell. Psychiatric Dic­ following sources: tionary. New York: Oxford University Press, 1970. Kadushin, Alfred. Child Welfare Services. New York: American Psychiatric Association. A Psychiatric Gloss­ The Macmillan Co., 1967. ary (4th ed.). New York: Basic Books, 1975. Kempe, C. Henry, and Ray Helfer. Helping the Battered Mate little Conception Barcy, William, Paul Glasser, and Ronald Lemley. Child and His Family. ~hiladelphia: J. B. Lippincott, help Child Abuse and Neglect, A Challenge to the Caring 1972. Community: Conference Guidebook. Lansing, Mich.: Klaus, Marshall, and John Klennel. Maternal-Infant Michigan Department of 'Social Services, Septem­ Bonding. St. Louis, Mo.: The C. V. Mosby Co., ber, 1977. 1976. Black, Henry C. Black's Law Dictionary, St. Paul, Martin, Harold P. The Abused Child: A Multidisciplin­ Minn.: West Publishing Co., 1968. ary Approach to Developmental Issues and Treatment. Bolton, F. G., Jr., and E. J. Kinsworthy. Source Book Cambridge, Mass" Ballinger, 1976. Selection of mate/ for Recommended Maltreatment Materials Packages. National Association of Social Workers. Encyclopedia Wanted and __ Pregnancy Phoenix: Arizona Community Development for of Social Work (16th issue). Washington, D.C.: Na­ U,.. ,,,, I Child Abuse and Neglect, 1977. tional Association of Social Workers, 1973. Children's Trauma Center, Children's Hospital, Oak­ National Center on Child Abuse and Neglect. Child \ land, Calif. Focus: Child Abuse and Neglect, Training 'Abuse and Neglect: The Problem and Its Management Selection of "friends" Wanted and __ Child Curriculum. Bethesda, Md.: National Institute of (3 vols.).Washington, D.C.: U.S. Department of Unwanted Mental Health, 1976. Health, Education and Welfare [DHEW Publica­ Fa,nn, William, and Charles Goshen. The Language of tion Nos. (OHD) 75-30073, (OHD) 75-30074, Mental Health. St. Louis, Mo.: The C. V. Mosby Co., (OHD) 75-30075], 1975. '''I'm no damm/ __ Inability to 1973. National Center on Child Abuse and Neglect. Model good" help others Frenay, Sister Agnes Clare, SSM. Understanding Medi­ Child Protection Act with Commentary (Draft). Wash­ cal Terminology (5th ed.). St. Louis, Mo.: Catholic ington, D.C.: U.S. Department of Health, Education Unrealistic Hospital Association, 1973. and Welfare, August, 1977. Expectations / / O'oldstein, Joseph, Anna Freud' and Albert J. Solnit. National Center on Child Abuse and Neglect. We Can Isolation __ Inability to Beyond the Best Interests of the Child. New York: The Help: A Curriculum on the Identification, Reporting, use others Free Press, 1973. Referral and Case Management of Child Abuse and / Hansen, Christian M., and the Staff of the Protective Neglect. Washington, D.C.: U.S. Department of \ Trust not Services Resource Institute. Failure-to- Thrive: A Health, Education and Welfare, 1976. Kole Reversal Learned Manual for Social Workers. Piscataway, N.J.: National Conference on Social Welfare. Summary, CMDNJ-Rutgers Medical School, March, 1977. American Families in Transition: Approaches to Helfer, Ray E. Child Abuse and Neglect: The Family and Family, Policy. Columbus, Ohio: National Con- ~ Compliance the Community. Cambridge, Mass.: Ballinger, 1976. ference on Social Welfare, 1977. • Helfer, Ray E. Child Abuse and Neglect: The Diagnostic National Institute for Advanced Studies. Report on Process and Treatment Programs. Washington, D.C.: Recommendations for Revisions to Standards, Con­ U.S. Department of Health, Education and Welfare tract No. HEW 105-76-1/90, Revision to Federal Helfer, 1915, p. 27 [DHEW Publication No. (OHD) 75-69], 1975. Standards on the Prevention and Treatment of Child Helfer, Ray E., and C. Henry Kempe. The Battered Abuse and Neglect (Draft), Washington, D.C.: U.S. Child (2nd ed.). Chicago: University of Chicago Department of Health, Education and Welfare, Press, 1974. July, 1977.

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93rd Congress. Public Law 93-247: Child Abuse Preven­ New York: Pocket Books, 1970. Office of Human Development Services), tion and Treatment Act. Washington, D.C.: U.S. Con­ Steele, Brandt F. Working with Abusive Parents from a PL 93·247 gress, January 31, 1974. U.S. Department of Health, Education Child Abuse Prevention and Treatment Psychiatric Point of View. Washington, D.C.: U.S. Polansky, Norman, Christine DeSaix, and Shlomo and Welfare Act Department of Health, Education and Welfare OHDS SCAN Sharlin. Child Neglect: Understanding and Reaching Office of Human Development Services Suspected Child Abuse and Neglect [DHEW Publication No. (OHD) 75-70], 1975. SIDS the Parent. New York: Child Welfare League of (formerly Office of Human Develop­ Sudden Infant Death Syndrome Steinmetz, Susan; and Murray Straus. Violence 'in the o STD America, 1972. ment), U.S. Department of Health, Sexually Transmissible Disease Family. New York: Dodd, Mead and Co., 1975. TPR Public Services Administration. Protective Services for Education and Welfare Termination of Parental Rights U.S. Department of Health, Education and Welfare. PA UM Abused and Neglected Children and Their Families: A i' Parents Anonymous Unmarried Mother "Child Abuse Prevention and Treatment Program." PET VD Guide for State and Local Departments of Public Parent Effectiveness Training Venereal Disease Federal Register, Vol. 39, No. 245, Part II (Decem­ WAR PINS Person in Need of Supervision World of Abnormal Rearing Social Services on the Delivery olProtective Services. ber 19, i974). pp. 43936-43941. WIN Washington, D.C.: U.S. Department of Health, Work Incentive Program U.S. Senate Committee on Finance. The Social Security Education and Welfare [DHEW Publication No. Act and Related Laws (as Amended Through Decem­ (SRS) 77-23042], 1977. ber 31, 1976). Washington, D.C.: U.S. Government Schifferes, Justus J. The Family Medical Encyclopedia. Printing Office, 1976.

Acronyms

AAP American Academy of Pediatrics CPS Child Protective Services ACSW Academy of Certified Social Workers CWLA Child Welfare League of America ACYF Administration for Children, Youth and DART Detection, Admission, Reporting, and Families (formerly Office of Child Treatment (multidisciplinary team) Development), U.S. Department of DD Developmental Disability Health, Education and Welfare DHEW U.S. Department of Health, Education ADC Aid to Dependent Children (Title IV-A and Welfare (also referred to as HEW) of the Social Security Act) (also referred DPW Department of Public Welfare to as AFDC) DSS AF Department of Social Services Alleged Father EPSDT AFDC Early and Periodic Screening, Diagnosis, Aid to Families with Dependent Children and Treatment (Title IV -A of the Social Security Act) ER Emergency Room (also referred to as ADC) FTT AHA Failure to Thrive American Humane Association GAL AMA Guardian ad litem Against Medical Advice; American HEW Medical Association U.S. Department of Health, Education APA and Welfare (also referred to as DHEW) American Psychiatric Association; IP Identified Patient American Psychological Association LD Learning Disability .APWA American Public Welfare Association MINS CALM Minor in Need of Supervision Child Abuse Listening Mediation NASW CAN National Association of Social Workers Child Abuse and Neglect NCCA CAP National Center for Child Advocacy Community Action Program NCCAN CDAHA National Center on Child Abuse and Children's Division of the American Neglect Humane Association NIH National Institutes of Health CDF Children's Defense Fund NIMH National Institute of Mental Health CES Comprehensive Emergency Services OCD Office of Child Development (now Ad­ CHIPS Child in Need of Protection and Supervi­ sion minstration for Children, Youth and Families), U.S. Department of Health, CLL Childhood Level of Living Scale Education and ,Welfare CNS Central Nervous System OHD Office of Human Development (now 44 "U.S. GOVERNMENT PRINTING OFFICE: 1980 620-232/4268 1-3 45

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