Archive for June, 2009

Child abuse and neglect.  This is a very difficult topic to discuss because it is so emotionally charged and unpleasant to consider, and yet we believe it is a subject that families and professionals ought to know more about. First of all, when we are talking about suspected child abuse or neglect, anyone in the general public can and should make a report to their state agency.  However, many professionals are required by law to make a report to the state in such a situation.  These are called mandated reporters.

A great many people are not fully educated about what mandated reporting means and who mandated reporters are.  Learning about this – and what you can do to ensure the safety and security of your own family – is critical.   We hope this information will be useful to you all.

The Illinois Department of Children and Family Services website defines a mandated reporter as any member of the following professional groups:

* Medical Personnel: Physicians, psychiatrists, surgeons, residents, interns, dentists, dentist hygienists, medical examiners, pathologists, osteopaths, coroners, Christian Science practitioners, chiropractors, podiatrists, registered and licensed practical nurses, emergency medical technicians, substance abuse treatment personnel, hospital administrators and other personnel involved in the examination, care or treatment of patients.

* School and Child Care Personnel: Teachers, school personnel, educational advocates assigned to a child pursuant to the School Code, truant officers, directors and staff assistants of day care centers and nursery schools, and child care workers.

* Law Enforcement: Truant officers, probation officers, law enforcement officers, and field personnel of the Department of Corrections.

* State Agencies: Field personnel from the Departments of Children and Family Services, Public Health, Public Aid, Mental Health and Developmental Disabilities, Corrections, Human Rights, Rehabilitation Services. Also includes supervisors and administrators of general assistance under the Illinois Public Aid Code.

* Others: Social workers, social service administrators, substance abuse treatment personnel, domestic violence program personnel, crisis line or hotline personnel, foster parents, homemakers, recreational program or facility personnel, registered psychologists and assistants working under the direct supervision of a psychologist, members of the clergy.

This is a very long list, and, yes, your child’s therapists are all included.  Consider any professional involved in the care or education of your child to be a mandated reporter.

What does this mean?  It means, according to the IL DCFS, that a professional must make a phone call to the local child abuse hotline in the following situations:

…whenever you believe that a person who is caring for the child, who lives with the child, or who works with or around children has caused injury or harm or put the child at risk of physical injury as defined in the Abused and Neglected Child Reporting Act.  Some examples include:

* If you see someone hitting a child with an object.

* If you see marks on a child’s body that do not appear to have been caused by accident.

* If a child tells you that he or she has been harmed by someone.

* If a child appears to be undernourished, is dressed inappropriately for the weather, or is young and has been left alone.

These are a few situations when you should call the hotline. Use your own judgment and call the hotline whenever you think a child has been abused or neglected. “

The first two points may be fairly straightforward for a professional.  However, when we are considering this issue as it relates to something a child with special needs has verbally reported to us, it can become very tricky.  For one thing, the child in question may have limited to no language – or perhaps has language that is unclear or primarily scripted from books or movies.  It may be difficult to interpret specifically what the child is communicating.  Many of our clients have challenges in the area of social communication and are just becoming more proficient in understanding vocabulary that describes emotion words and learning to read the social cues of others; there is certainly room for misinterpretation.  In such situations, professionals must use their clinical knowledge of the child to make a judgment call.  They must also observe the child’s body language; for example, if the message is somewhat confusing but the child is curled in a ball sucking his thumb for comfort and looking very upset when expressing it, this is important non-verbal information to attend to.

It is helpful to initially call the local hotline and present the situation; the operators are generally well trained and will be open to having a conversation that includes information about the child’s communication challenges and your concerns about misinterpretation.  After talking it through, the operator will help the professional determine if she has a situation that warrants a report.

As a parent, what can be most difficult to comprehend is that even a therapist who has known you for a period of time, and who likes and respects you, is obligated by law to call the hotline if the criteria above are met.  A professional can not simply take you aside or call you on the phone to discuss what has been observed or communicated that makes her suspect abuse or neglect.  To do so puts that professional in grave jeopardy should these suspicions be substantiated later on; at the very least, that professional would be on the fast track to losing her license to practice.  More importantly, it may put the child in grave jeopardy as well.

Please keep in mind that even people we like and have personal relationships with may have challenges with managing their anger and frustration when truly stressed in the home environment.  While these behaviors don’t always hurt the child they may well frighten him into feeling that he could be harmed at any moment.  We simply cannot know exactly what happens when we are not present but must rely on what we see and hear.  This is not the time to give people we like the benefit of the doubt, difficult as that is.

So what can a parent do? You are by no means helpless to prevent such an occurrence.  Here are some suggestions:

1. Be completely honest with yourself.  How are you and the other adults in your child’s life coping with stress, frustration, and anger?  Do any of you feel out of control at times?  Is your child getting hurt or scared by this?

2. Be completely honest with the professionals in your child’s life.  We understand that your situation can become challenging and are here to assist you, not to judge you.  We can confidentially share resources to support you with parenting strategies, personal and/or family counseling, and respite care.  Sit down privately with a trusted professional and be very clear in your communication: “I am really losing my patience with my child and sometimes I start to feel out of control.  I need help.”  Please bear in mind that we would much rather hear this from you and be given an opportunity to help you than to hear it from your child and have to call the DCFS hotline.

3. If your child takes a spill and has unusual bumps or bruises, be sure to let those who work with the child know what happened.  We know that some children with coordination challenges fall or trip often and we are also aware of children who have self-injurious behaviors.  It is critical to keep the lines of communication open so that everyone who cares for or works with your child is aware of these things.  (And professionals must be sure to report any falls or bumps that take place when they are with the child as well.)

Please keep these suggestions in mind and share them with other parents and professionals so that we might prevent neglect, abuse, and misunderstandings from occurring.  The first priority of professionals working with your child is always the care and safety of your child and entire family.

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