Transcription:
Child Abuse Prevention

Melanie Cole (Host): As a parent, I find it impossible to imagine anyone neglecting or abusing a child. However, it happens to so many kids, all around the world, every year. And it is heartbreaking. What can we do to help the situation, to get involved? My guests in this panel discussion today are Kara Scott, she’s a nurse practitioner and Wally Bellis, he’s a senior social worker in the Department of Pediatrics in the Division of Forensic Medicine and they’re both at UK Healthcare. Wally, I’d like to start with you. Give us a little information on some statistics for how many children are abused and neglected each year and how many children actually die from this abuse and neglect?

Wally Bellis MSW (Guest): Melanie, that’s a wonderful question and actually we have some very recent data. The Children’s Bureau of the US Department of Health and Human Services just released their annual report a few months ago. And this report took a look at abuse statistics around the United States for the year 2017. And unfortunately, Kentucky ranked first in its rate of child abuse out of all the states in the United States. We have a total of 22,410 child victims of abuse and neglect in 2017. And that puts us at about per every 1000 children in Kentucky, 22 are suffering some form of maltreatment. And sadly, that’s more than double the national average of just a little over 9 per 1000.

So, and you had asked I believe about fatalities which is another horrific figure. The Kentucky Child Fatality and Near Fatality Review Panel released their report just a bit ago from 2018. In Kentucky alone, there was 134 total cases of fatalities and near fatalities. And if I remember correctly, I believe that we had 16 total fatalities in Kentucky that were due to maltreatment for the year 2018.

Host: Wow, those are staggering Wally and as you said, horrific statistics and while this is a difficult discussion to have and difficult to hear those kinds of statistics; tell us what’s the difference between neglect and abuse Wally if you would. Just kind of set that stage for us so that we know what we’re talking about today.

Wally: Sure. I think that’s a really good question and quite simply neglect is basically an act of omission. It’s a willful not providing a basic need for a child and when we think about neglect, we think about things like basic needs; food, shelter, clothing. But it can also include things such as educational neglect, medical neglect, even environmental. So, whereas neglect is kind of a parent or a caregiver having the ability but just not meeting the child’s needs; physical abuse would be more of an infliction, inflicting some type of physical injury on a child. It can be hitting, kicking, slapping, et cetera, but it is that act where something happens or is done by the parent and results in an injury to the child.

Host: How awful. Kara, Wally just said, and it’s done by the parent. It’s not always the parent, correct? I mean why, I don’t know that you can even answer the why but who is most often doing the abusing? Is it relatives, is it strangers, caregivers? Who is doing this most often?

Kara Scott DNP, APRN (Guest): We honestly see abuse inflicted by multiple individuals whether that be a parent, a relative, a daycare provider, a babysitter. Unfortunately, we see a wide range of perpetrators.

Wally: If I could, I would like to add. One of the more I guess common types of perpetrator that we see is oftentimes an unrelated male that’s in the home. And one of the things that we try to do here is lots of education for single parents on how to select individuals in the home that are going to be safe around the children and around the parent themselves.

Host: I think that’s one of the most important points we are going to make in this podcast today. Kara, what are the signs and symptoms of child abuse and neglect that we might notice or that the school would notice and let us know about? What should we be looking for?

Kara: What we use as a great guideline for individuals to be aware of is something called the ten four bruising rule. And what that rule entails is any child who is four years of age or younger should not have any bruising on their torso, their ears or their neck. And that also includes any child under four months of age should not have any bruising. Bruising on babies is not normal. And these are significant indicators of abuse.

We also say that those who don’t cruise rarely bruise. So, if a child is not able to pull up on furniture and cruise other objects; they should very, very rarely have any type of bruising.

Host: Then what do we do? Wally, I’m going to start with you. I want you both to answer this question. What do we do. If we’re a parent and our child comes home from the daycare or from a babysitter or God forbid, from school or a friend’s house and we notice some of those bruises or they are pulling back from us, or they are recoiling when we try to hug them or any of these other things. What do we do? Who do we report it to? Do we try and investigate ourselves first? What do we do?

Wally: I think that’s a really good question Melanie and really our first inclination as parents is to do investigation but what I would encourage folks to do, if they have concerns, if their child comes home from the daycare or from the sitter’s house and has bruises like Kara mentioned that would be considered suspicious; the first thing that the parent needs to do is to pick up the phone and notify the state social services agency here in Kentucky. It’s the Department for Community Based Services. And they have a hotline that any of us can call. As a matter of fact, the law in Kentucky is very simple. We are all, as citizens of this state, mandatory reporters for suspected child abuse.

But if you call 1-877-KYSAFE1, that’s Kentucky safe 1; that phone line is manned 24 hours a day and there will be somebody there to take the concerns, to measure that with their protocol and their policies to make sure that it meets the criteria for investigation and if so, become involved and perform a formal investigation of potential child abuse. Again, that’s 877-597-2331.

Host: So Kara, on to you now because one of the things that parents might be concerned about when calling these number is that people are going to think it’s them and that their children could get taken away from them so they might be hesitant to report this. What do you want them to know about that?

Kara: I want them to know that it is crucial that this be reported. A formal investigation will be conducted and it’s extremely thorough and will go into detail about the events leading up until the injury was discovered. Other caregivers, other environments. It’s going to be a very thorough and detailed investigation and it’s so crucial to make sure that that is reported so that this injury is investigated.

Host: And are there signs Kara, of sexual abuse that might be different than the bruising that we’ve been talking about for physical abuse? Is there something we would notice in a child and while you’re answering that, do we ask the child, depending on their age I suppose, but do we ask the child has somebody been doing this or did somebody hit you or push you or sexually abuse? How do we approach this with our children?

Kara: I think it’s very important to have open communication with your child. And first thing first, I think is educating children and letting them know what kind of touch is okay, what it not okay, teaching them correct names for body parts. Things like that to make sure that they are educated. And I do think it’s important to have that open line of communication.

Wally: I’d like to add to just what Kara is saying. Open communication is a parent’s best defense with any type of sexual abuse, making sure you have that conversation, just like Kara said, that the kids are somewhat educated and that’s really the best tool that we as parents have in our arsenal of protecting our children.

Host: So, how do we check out a daycare or a babysitter? Wally, why don’t you answer this one for us first. What are we looking for because we hear about these horrific cases at daycare? How do we know?

Wally: So, first and foremost, when you go to the daycare, there are several things that you might want to look for. Making sure that they have4 some kind of a license or certificate posted somewhere where we can see it, showing that they are truly certified by the state to provide childcare. You may want to check to see where they put their compliance reports and take a look at those to make sure that as they get their inspections, that they are truly in compliance with state regulations.

One of the big things that parents can do is after you’ve taken a look at your daycare, you may go to several of them as you are searching for a place to provide care for your child. When you find the one that you are interested in, or maybe a couple, the best thing to do is to pick up the phone and call the Division of Regulated Childcare here in Kentucky. If you call 502-564-7962 and tell them the daycare that you are looking at; they’ll be able to run that center through their system and tell you whether or not there has been any history of complaints.

That’s run through the Office of the Inspector General here in Kentucky and actually if you’re interested parents out there and caregivers; you can Google OIG Kentucky, that’s really the best way to remember it and it will take you straight to the page for the Division for Childcare. There’s a wonderful tip sheet on there that you can print off and use for things specifically to look for as you go and try to select that perfect center for your child.

Host: What great advice. Kara, what would you like the listeners to take away from this segment and as we said, as hard as it is to talk about, it must be talked about. And it must be recognized. So, we all have to know those signs and be able to know where to report. What would you like them to know about child abuse and neglect, sexual abuse and hopefully preventing it from happening in our state?

Kara: I think that it is so important to know what to look for. Like we discussed, the ten four bruising rule. If an individual sees a bruise on the child where there is concern, it is so important to go ahead and make that report. The safety of the child is in their hands and they can save their life by making that report and getting that investigated.

Host: Wall, last word to you. What would you like the listeners to know about child abuse prevention, recognizing as Kara said, the symptoms and the resources that are available through UK Healthcare and other places?

Wally: I think one of the big things is I would like for folks to understand, we’ve talked a lot about reporting and where to call to make the report. Sometimes people are very much afraid that there might be some kind of repercussions that the person they are making the report on might be told that it was them. I just want to make sure that everybody understands; when you pick up the phone and you call the hotline and you make the referral; it is up to you whether or not you provide your name and your contact information. If you are just absolutely uncomfortable giving them your name; you can make that report anonymously. So, fear for being recognized or for the parent knowing where the referral came from; I’d just like to put that to rest for folks.

Host: I think this is all such great information and so important and thank you both for being on with us today and also thank you for all you do. Because what an important job that you both have, and I can hear the passion in your voice and thank you so much again for all that you are doing for the children of Kentucky.

That wraps up another episode of UK HealthCast with The University of Kentucky Healthcare. You can head on over to our website at www.ukhealthcare.uky.edu for more information and to get connected with one of our providers. If you found this podcast informative as I did, please share with friends and family, share with people that you know, share on your social media, because that’s how we all learn together from the experts and that’s how we can all hopefully prevent some of these cases of child abuse and neglect. Thank you so much for listening. Until next time, I’m Melanie Cole.