Recognizing the signs and symptoms of child abuse

RBC I Physical abuse is when there is evidence the child has experienced physical harm or injury by the parent or caretaker, or has been subject to circumstances that could reasonably pose a serious threat of physical harm or injury and “either the condition or death is not justifiably explained; the explanation or history given varies from the child’s appearance or from the degree or type of such condition or death; or the circumstances indicate that the injury or condition may not be accidental.”
According to the Colorado Children’s Code (19-1-103), “abuse” or “child abuse or neglect,” means an act or omission in one of the following categories which threatens the health or welfare of a child:
n Any case in which a child exhibits evidence of skin bruising, bleeding, malnutrition, failure to thrive, burns, fracture of any bone, subdural hematoma, soft tissue swelling, or death and either: such condition or death is not justifiably explained; the history given concerning such condition is at variance with the degree or type of such condition or death; or the circumstances indicate that such condition may not be the product of an accidental occurrence;
n Any case in which a child is subjected to sexual assault or molestation, sexual exploitation or prostitution;
n Any case in which a child is a child in need of services because the child’s parents, legal guardian, or custodian fails to take the same actions to provide adequate food, clothing, shelter, medical care or supervision that a prudent parent would take.
n Sexual abuse is when a child or adolescent has been subjected to assault, has been molested, or has been sexually exploited or prostituted. Both boys and girls, at any age, can be victims of sexual abuse. The vast majority of sexually abused children have no injuries that can be observed by anyone, including a health care provider. The few sexually abused children who do have physical indicators will be diagnosed by a physician.
Neglect is a complex and often dangerous situation for children. In Colorado, more children die from neglect than from physical abuse. Thus, when a child’s basic needs for adequate food, clothing, shelter, medical care, or supervision are not being met as a prudent parent in the same circumstances would meet them, the situation must be taken very seriously.
Circumstances of poverty can result in difficulty in meeting the children’s needs, however this is not the same as neglect. Parents who have financial difficulty in meeting their children’s needs can be referred to community resources such as food banks, shelters, and low-cost day care facilities.
A child is neglected or dependent if (Colorado Children’s Code: 19-3-102):
n A parent, guardian, or legal custodian has abandoned the child or has subjected him to mistreatment or abuse or a parent, guardian, or legal custodian has suffered or allowed another to mistreat or abuse the child without taking lawful means to stop such mistreatment or abuse and prevent if from recurring;
n The child lacks proper parental care through the actions or omissions of the parent, guardian or legal custodian;
n The child’s environment is injurious to his or her welfare;
n A parent, guardian or legal custodian fails or refuses to provide the child with proper or necessary subsistence, education, medical care, or any other care necessary for his health, guidance or well-being;
n The child is homeless, without proper care, or not domiciled with his or her parent, guardian or legal custodian through no fault of such parent, guardian, or legal custodian;
n The child has run away from home or is otherwise beyond the control of his or her parent, guardian or legal custodian;
n A parent, guardian or legal custodian has subjected another child or children to an identifiable pattern of habitual abuse; and
n Such parent, guardian or legal custodian has been the respondent in another proceeding under this article in which a court has adjudicated another child to be neglected or dependent based upon allegations of sexual or physical abuse, or a court of competent jurisdiction has determined that such parent’s, guardian’s, or legal custodian’s abuse or neglect has caused the death of another child; and
n The pattern of habitual abuse …and the type of abuse pose a current threat to the child.
n Emotional maltreatment is when the parent or caretaker’s acts or omissions have caused or are likely to cause identifiable and substantial impairment to the child’s psychological or intellectual capacity or functioning or when the child is severely emotionally disturbed and is not receiving appropriate treatment.
Accident vs. Abuse
When a child appears to be physically injured, for instance, there appears to be bruising, bleeding, burns, fracture of any bone, cuts bites, soft tissue swelling, or death, and there is reason to believe that the cause may not have been accidental, physical abuse may be indicated.
N Bruises — A bruise’s location can sometimes help determine if the cause was accidental or the result of abuse. Accidental bruises or “play bruises” are more likely to occur on bony prominences such as knees, shins, forehead, or elbows. Bruises in specific shapes such as hand or finger marks (from grabbing or slapping), loop marks (from a belt or cord), and hanger marks are possible indicators of physical abuse, as are bruises on the face, arms, buttocks, lower back and lateral thighs (often due to being struck).
N Burns — Accidents do happen. However, abusive burns usually are distinctively different from accidental burns. Abusive burns have clear lines defining the skin and are often deep. Accidental burns tend to be scattered on the skin and do not penetrate as deeply.
n Fractures — Accidental fractures are often a normal part of the rites of childhood. Children fall out of trees, wreck their bikes, and fall from skateboards. Fractures can also be present at birth as a result of delivery. Breech births frequently cause injury. CPR in adults may cause broken ribs, however it rarely does in small children. Unexplained fractures, particularly under the age of two should be closely examined.
n Lacerations/abrasions — Unexplained lacerations and abrasions, particularly to the mouth, lips, gums, eyes, genitalia, or backs of arms, legs or torso are highly suspect and should be assessed by a physician. Adult human bite marks, unexplained abdominal injuries (such as a swollen abdomen, localized tenderness, and constant vomiting) and/or inconsistent reports of the injuries should be reported immediately.
n Head and Brain Injuries — Traumatic births may result in head injuries. However, if the injury is not noticed within a few days of birth, child abuse should be suspected. Head and brain injuries can occur from falls and car accidents as well as shaking and beating.
n Poisoning — Sometimes parents will give children roots or herbs to cure a common malady and the treatment has an unfortunate side effect of poisoning. Education and support should be of great help in these situations.
In all cases, the child and caretaker’s story of the incident that caused the injury is critical to determining whether it is abuse or accidental.
If you have concerns or questions about suspected child abuse and/or neglect, please contact the Rio Blanco County Department of Social Services, 970-878-9640 in Meeker or 970-878-9645 in Rangely.