Child Welfare & The Mandated Reporter R[2]

RCDS: Early Intervention & Enrichment
Program

Presents

Child Abuse & Neglect:
Prevention & The Role of
The Mandated Reporter
Facilitated by:

Dawn Mastoridis, M.Ed., CAGS
Executive Director, RCDS
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About Your Speaker: Dawn Mastoridis

In August of 2007, I joined The MENTOR Network as their State Director for the New York
area. The MENTOR Network is a national human service organization that offers a wide range
of community-based programs for at-risk adults & children. I serve as the Executive Director for
Rockland Child Development Services (RCDS) which provides home, community & center-
based Early Intervention services within the Bronx, Queens, Brooklyn & Manhattan as well as
Rockland & Orange County.

I have been a ‘Mandated Reporter’ for over 20 years. Early in my career, I served as an
Outpatient Substance Abuse Therapist in Massachussetts working with families & individuals
affected by alcohol or drug abuse. My history within the Early Intervention {EI} Program dates
back to 1993 when I developed one of the first home/community based EI Programs to serve
Brooklyn & Queens. However, I am most well-known for establishing & directing the EI
Program for Personal-Touch Home Care from 1995 to 2006. Additionally, I have served as an
Adjunct Instructor at Daemen College’s Special Education graduate program (TTI) based in
Brooklyn. My credentials include a M.Ed. in Counseling & Psychological Services as well as a
Certificate of Advanced Graduate Studies {CAGS} in Marriage & Family Therapy.

As part of RCDS’ Community Outreach Program, I periodically facilitate workshops on a wide
range of topics including but not limited to Child Abuse & Prevention.
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~ www.rcdseip.com ~ 1

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Common Myths About Parenting or Caring For Children
MYTH #1: Most people, especially women, instinctively know how to care for
children
Fact: FALSE. Caregiving skills are not innate or the same for most people. Research
indicates parenting/caregiving skills are largely influenced by a person’s own childhood
as well as their natural temperament, parental expectations, immediate resources
and basic coping skills.

MYTH #2: All children are ‘lovable’ & require the same basic caregiving skills.
Fact: FALSE. While all children DESERVE & NEED love, there are many individual differences
that can make it a big challenge for caregivers or parents. Caregiver or parenting skills that
work with some children may be ineffective for others. Regardless of whether a child is
typically developing or delayed; a child’s temperament, personality or behaviors may
require much more time & energy to address than another child.

MYTH #3: A ‘good’ parent must be highly involved or in control of their child’s life.
Fact: FALSE. In recent years a new term called helicopter parents has been coined to
describe parents who micromanage or are hyper-involved in the lives of their children.
However, a recent study has concluded that having so-called "helicopter parents" was
associated with children becoming dependent, neurotic and less open as well as a slew of
personality traits that are generally thought of as undesirable. 3

Common Myths and Facts about Child Abuse & Neglect
MYTH #1: It's only abuse if it's violent.

Fact: Physical abuse is just one type of child abuse. Neglect and emotional abuse
can be just as damaging, and since they are more subtle, others are less likely to
intervene.

MYTH #2: Only “bad” people abuse their children.

Fact: While it's easy to say that only "bad people" abuse their children, it's not
always so black and white. Not all abusers are intentionally harming their children.
Many have been victims of abuse themselves, and don’t know any other way to
parent. Others may be struggling with mental health issues or a substance
abuse problem.

MYTH #3: Child abuse doesn't happen in “good” families.

Fact: Child abuse doesn't only happen in poor families or bad neighborhoods. It
crosses all racial, economic, and cultural lines. Sometimes, families who seem to
have it all from the outside are hiding a different story behind closed doors.

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Part I:
The History of “Legalized”
Child Protection

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The History of Child Protection

 In 1866, Henry Bergh, a
philanthropist and
diplomat, who recognized
the inhumane treatment
suffered by many
“animals” in our society,
founded the American
Society for the Prevention
of Cruelty to Animals
(ASPCA) prompting the
New York state legislators
to pass the country's first
effective anti-cruelty to
animals law.

 The ASPCA is the oldest
humane organization in
America.

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 Eight years later, a young girl was
found tied to a bed like an animal,
neglected and brutally beaten by
her foster parents.

 In 1874, animals were legally
protected from inhumane
treatment, children weren't.

 Child abuse and neglect was
considered a family matter and
there was no one to intervene on
behalf of the child.

 That is until a small group of
concerned citizens in New York City
came together in 1875--with the www.nyspcc.org/nyspcc/programs/idrep/

assistance of Henry Bergh-- to
become the first organized child
protective institution in the world--
The New York Society for the
Prevention of Cruelty to Children
(NYSPCC).
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So let’s meet the little girl
who started it all…

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Meet Mary Ellen McCormack-Wilson
at 10 years of age

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We meet Mary Ellen by way of an excerpt
from her testimony in a New York City
courtroom in 1874.

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courtroom in 1874.
 My name is Mary Ellen McCormack. I don't
know how old I am...

 I have never had but one pair of shoes, but
I can't recollect when that was. I have no
shoes or stocking this winter...

 I have never had on a particle of flannel.

 My bed at night is only a piece of carpet,
stretched on the floor underneath a window,
and I sleep in my little undergarment, with a
quilt over me.
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courtroom in 1874.
 I am never allowed to play with any children or
have any company whatever.
 Mamma has been in the habit of whipping and
beating me almost every day.
 She used to whip me with a twisted whip, a raw
hide. The whip always left black and blue marks on
my body.
 I have now on my head two black and blue marks
which were made by mamma with the whip, and a cut
on the left side of my forehead which was made by a
pair of scissors in mamma's hand.
 She struck me with the scissors and cut me.

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courtroom in 1874.
 I have no recollection of ever having been kissed,
and have never been kissed by mamma.

 I have never been taken on my mamma's lap, or
caressed or petted.

 I have never dared to speak to anybody, because
if I did I would get whipped.

 Whenever mamma went out I was locked up in the
bedroom...

 I have no recollection of ever being in the street
in my life.
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courtroom in 1874.
 After Mary Ellen told her story in court, her foster
mother was prosecuted for assault and battery.

 Mary Ellen was placed into a new home in upstate
New York and grew up a normal child.

 She became a favorite to all those who knew her.

 At twenty-four she married and had two
daughters of her own. She also adopted a third
orphaned child.

 Her daughters reported that Mary Ellen was always
reluctant to speak of her past, but she did show them
the scars of burns on her arms and the scissor
scar was always noticeable on her face.

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courtroom in 1874.

 It was her pride and joy to be able to
provide her own daughters with a happy
childhood in contrast to her own.

 Mary Ellen died in 1956, at the age of 92

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 Thus ... the beginning of an American
society to confront its inherent moral
obligation to protect kids --- even from
their parents. But, reporting abuse was
not required; reports stemmed only from
incidents which involved serious physical
injury or death.

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 And so it was, still in the
late 1950's, what happened
in the family was regarded
as a very private manner;
children were considered
their parent's chattel,
until:

 In 1962, Dr. Henry C.
Kempe described "The
Battered Child
Syndrome" and urged
physicians to report
suspected child abuse.

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 Eventually many states
responded to their
perceived moral and legal
responsibility by making
child abuse a criminal act
during the late 1960's.

 However, reporting child
abuse was still not legally
required. Consequently,
most incidents of
suspected child abuse
remained behind closed
doors and were neither
acknowledged nor
challenged.

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 Finally in 1974, The United States
Congress, in enacted the Child
Abuse Prevention and
Treatment Act (CAPTA), which
provided federal funds -
dedicated to prevent child abuse -
for states that passed laws
requiring certain professionals
(law enforcement professionals,
educators, and medical and
mental health care professionals)
to report suspected child
maltreatment.

 In short order, every state had
mandatory reporting laws
enacted in their legislatures.

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Child Abuse Prevention and Treatment Act (CAPTA) of 1974
P.L. 93-247

Major Provisions of the Act

• Provided assistance to States to develop child abuse and neglect identification and
prevention programs

• Authorized limited government research into child abuse prevention and treatment

• Created the National Center on Child Abuse and Neglect (NCCAN) within the
Department of Health, Education, and Welfare to:
- Administer grant programs
- Identify issues and areas needing special focus for new research and
demonstration project activities
- Serve as the focal point for the collection of information, improvement of
programs, dissemination of materials, and information on best practices to States and
localities

• Created the National Clearinghouse on Child Abuse and Neglect Information

• Established Basic State Grants and Demonstration Grants for training personnel and
to support innovative programs aimed at preventing and treating child maltreatment
* http://www.childwelfare.gov/systemwide/laws_policies/federal/index.cfm?event=federalLegislation.viewLegis&id=2

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New York State's Child Protective
Services Act (1973)
In order to protect children who are victims of abuse or
maltreatment, New York, like most states, created a child protective
system in statute with five fundamental components:

1. detection through third-party recognition of children in danger,
including mandatory and voluntary reporting of suspected child abuse
and maltreatment;
2. emergency protective custody of children in "imminent danger";
3. State Central Register of reports of suspected child abuse and
maltreatment;
4. child protective services (a) to verify reports, (b) to provide
immediate protection of children and (c) to begin the process of helping
families by providing rehabilitative and ameliorative services;
5. and, when necessary, court action - Family Court action to remove a
child, remove the allegedly abusive or neglectful parent from the child’s
residence, impose treatment and/or Criminal Court action (by
referring the case to law enforcement) to prosecute the perpetrator.

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The Purpose of New York State's
Child Protective Laws
• Abused and maltreated children in this State
need an effective child protective service to
prevent them from suffering further injury
and impairment.

• The purpose of the Child Protective Services
Act and amendments is to encourage more
complete reporting of child abuse and
maltreatment. The law establishes a child
protective service in each county of the
State. Each child protective service is required
to receive and investigate child abuse and
maltreatment reports, to protect children from
further abuse or maltreatment, and to provide
rehabilitative services for the children, parents,
and other family members involved.

• The purpose of the Family Court Act’s child
abuse and neglect provisions is to help
safeguard the physical, mental, and emotional
well-being of abused and neglected children by
establishing civil procedures to protect them.
The Family Court Act provides a due
process for determining when the State,
acting on behalf of the child, may intervene
against the wishes of the parent or other person
legally responsible for the child’s care so that
the child’s needs are properly met. 24

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Child Protection Act Law
 The main child protection
act is the federal National
Child Protection Act of
1993, although many
similar state acts have been
enacted.

 The purpose of the National
Child Protection Act of 1993
is to encourage states to
improve the quality of their
criminal history and child
abuse records.

 The Act was passed in
October 1993 and
amended in the Crime
Control Act of 1994.

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Child Protection Act Law
 Requires states to submit
"child abuse crime
information" to, or index
such information in the
national criminal history
background system
maintained by the FBI.

 Provides that a state’s
reporting all felonies
and serious
misdemeanors to the
FBI will satisfy this
requirement of the Act.

 Mandates that the U.S.
Attorney General
establish timetables for
each state’s criminal
history records system
to reach milestones for
improvement and
completeness.
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Infant Safe Haven Law
 Many State legislatures have enacted legislation to address infant
abandonment and infanticide in response to a reported increase in the
abandonment of infants.

 Beginning in Texas in 1999, "Baby Moses laws" or infant safe haven laws
have been enacted as an incentive for mothers in crisis to safely relinquish
their babies to designated locations where the babies are protected and
provided with medical care until a permanent home is found.

 Safe haven laws generally allow the parent, or an agent of the parent, to
remain anonymous and to be shielded from prosecution for abandonment
or neglect in exchange for surrendering the baby to a safe haven.

 To date, approximately 47 States and Puerto Rico have enacted safe
haven legislation. The focus of these laws is protecting newborns.

 In approximately 15 States, infants who are 72 hours old or younger may
be relinquished to a designated safe haven.

 Approximately 14 States and Puerto Rico accept infants up to 1 month
old. Other States specify varying age limits in their statutes.
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Summary of State Laws

New York

 Infant’s Age Citation: Penal Code §§ 260.03; 260.15: A child who is not more than 5 days old may be relinquished.

 Who May Relinquish the Infant Citation: Penal Code §§ 260.03; 260.15: The child may be relinquished by his or her
parent.

 Who May Receive the Infant Citation: Penal Code §§ 260.03; 260.15: The child may be left with an appropriate
person at a suitable location.

 Responsibilities of the Safe Haven Provider : This issue is not addressed in the statutes reviewed.

 Immunity for the Provider: This issue is not addressed in the statutes reviewed.

 Protection for Relinquishing Parent Citation: Penal Code §§ 260.03; 260.15: Relinquishment of the child to a safe
haven is an affirmative defense to prosecution for abandonment or endangering the welfare of a child.

 Effect on Parental Rights Citation: Soc. Serv. Law § 358-a: Reasonable efforts to reunify the child with his or her
parent are not required when a court has determined the child was abandoned by the parent with an intent to wholly
abandon such child.

Adapted From: www.childwelfare.gov/systemwide/laws_policies/statutes/safehaven.cfm. 28

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Parents who are unable to care for their
newborn infants may anonymously and
legally leave their infant at a safe place such
as a hospital. Call: 866-505-SAFE (7233)

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Part II:
Documenting & Reporting Child
Abuse or Neglect

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The State Central Register (SCR) of
Child Abuse and Maltreatment
• The New York State Office of Children and Family Services (OFCS) maintains a
statewide Central Register of Child Abuse and Maltreatment for reports made pursuant to
the Child Protective Services Act. The Central Register, also know as the "Hotline,"
receives telephone calls and faxes alleging child abuse or maltreatment.

• The Register screens out those calls and faxes which do not constitute abuse or
neglect or are otherwise inappropriate for the Register. The Register creates a
written report of the call and transmits it electronically to the local child protective service
for investigation, monitors the provision of child protective services and is capable of
immediately identifying the existence of prior child abuse or maltreatment reports.

• The Central Register receives telephone calls alleging child abuse and maltreatment
twenty-four hours a day, seven days a week. The calls come from two sources:
persons who are required by law to report suspected cases of child abuse and
maltreatment and voluntary reporters.

• All voluntary reporters may use the statewide, toll free number to report
suspected cases of child abuse or maltreatment. The statewide, toll free
number is: 1-800-342-3720.

• NYS MANDATED REPORTERS must call: 1-800-635-1522

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New Guidelines for Mandated Reporters
 Beginning October 1, 2007, those
mandated reporters who work for a
school, child care provider, foster
care facility, residential care facility,
hospital, medical institution or mental
health facility, and who have direct
knowledge of any allegation(s) of
suspected child abuse or
maltreatment, must personally
make a report to the SCR.

 Afterwards, that reporter should
then notify the person in charge of
the institution that a report has
been made. The person in charge is
then responsible for all subsequent
internal action that must follow such
a report.

 This may include providing follow-
up information to child protective
services (CPS), for example,
relevant information contained in the
child’s educational record. 32

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Reporting Suspected Abuse or Neglect
FORM LDSS- 2221-A

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Documentation Guidelines for
Mandated Reporters
ELEMENTS OF OBJECTIVE DOCUMENTATION

ALWAYS Use concrete, descriptive language
• Example: Dinner dishes were encrusted with old food.
• Not: Poor hygiene was evident.

Record evidence of the senses such as things seen, heard, smelled, tasted and touched
• Example: Therapist observed Mrs. Jones hitting Jimmy several times with a
belt, causing him to scream loudly.
• Not: Mrs. Jones is an abusive parent.

Use words with clear meanings and avoid value-laden terms
• Example: Mr. Smith argued with the neighbor.
• Not: Mr. Smith is belligerent.

Fully identify persons, places, direct quotations and sources of information
• Example: The client’s mother, Mrs. Wasson said “I can’t meet today.”
• Not: It was noted that Mrs. Wasson refused to meet today

Record facts, not an evaluation of the facts
• Example: Sally missed her appointment three times last week.
• Not: Sally was absent from treatment because she hates therapy.

Clearly label your impressions and base them on observable information
• Example: I believe that Mrs. Kent cannot care for her children because she
failed to visit or contact them or me for over six (6) months.
• Not: Mrs. Kent wants her children to remain in foster care.
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Mandated Reporters
IF you begin to develop concerns about a child’s welfare, Mandated Reporters, should begin
keeping a comprehensive record even prior to placing a report:

 Step 1: Record your concerns immediately. Always include the date and time of the
incident.

 Step 2: Document facts, not opinions. If a child has a bruise, for example, write down
the color, location and size of the bruise. It is unnecessary to include your opinion about
how you think it may have occurred.

 Step 3: Write down what the caregiver told you about the incident or injury. You'll also
want to include what the child, sibling or other witness said about the incident.

 Step 4: Collect the names and contact information of everyone involved in the incident.
While it is not your job to investigate a report, you'll want to provide all of this information
to the child services agency investigator or law enforcement officer to ensure that they
can gather all of the necessary information and evidence.

 Step 5: Sign, date and include the time of each entry.

 Step 6: Report your concerns to the appropriate child protection agency and make
sure you write down the name of the person you spoke with along with any
suggestions or advice they offered. Write down the date and time of your formal report.

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Mandated Reporters
 Always document your concerns using
pen and your own handwriting. If you need
to change an entry, cross it out with a single
line and initial it. It is important to stay away
from using white out to correct entries.

 Keep your written recordings in a safe
place. The court system or investigator may
request them during a formal investigation.

 If you have any suspicion whatsoever that a
child is being abused or neglected it is
imperative that you call your local child
protective services hot line immediately.

 Documentation can be used as a means
for supporting your concerns in the event
of a formal child abuse investigation. It is
imperative that you follow up any
documented concerns with a formal report to
your local child abuse and neglect hot line.

 If the child is injured or the situation
requires immediate attention, do not take
the time to document your concerns.
Call 911
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Legal Protections for
Mandated Reporters
What Protection or Liability Do I Have?
Source Confidentiality
 The Social Service Law provides confidentiality for mandated reporters and all sources
of child abuse and maltreatment reports. OCFS and local CPS are not permitted to
release to the subject of the report any data that would identify the source of a
report unless the source has given written permission to do so. Information regarding
the source of the report may be shared with court officials, police, and district attorneys
but only in certain circumstances.

Immunity from Liability
 If a mandated reporter makes a report with earnest concern for the welfare of a child,
he or she is immune from any criminal or civil liability that might result. This is
referred to a making a report in "good faith".

Penalties for Failure to Report
 Anyone who is mandated to report suspected child abuse or maltreatment - and fails to
do so - could be charged with a Class A misdemeanor and subject to criminal
penalties. Further, mandated reporters can be sued in a civil court for monetary
damages for any harm caused by the mandated reporter's failure to make the report to
the SCR.

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Part III:
Defining Child Abuse &
Neglect

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Five Basic Types of Abuse:

 Physical Abuse
- Shaken Baby Syndrome (SBS)

 Medical Abuse
- Munchausen by Proxy Syndrome (MBPS)

 Sexual Abuse

 Child Neglect

 Emotional Abuse
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Physical Abuse

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Physical Abuse

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Physical Abuse;
A Case Example

Adapted From: http://gothamist.com/2010/04/15/man_charged_with_fatally_punching_7.php
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Physical Abuse:
Shaken Baby Syndrome
Shaken Baby Syndrome: Defined

• Shaken Baby Syndrome (SBS) is caused by vigorous shaking of an infant
or young child by the arms, legs, chest or shoulders. Long-term consequences
can include learning disabilities, physical disabilities, partial or total blindness,
hearing impairment, speech disabilities, cognitive disabilities, cerebral palsy,
seizures, behavioral disorders and death.
Scope of the Problem
• More than one million children are
severely abused annually. Shaken Baby
Syndrome (SBS) is a leading cause of
morbidity and mortality in infants.

• In the United States, the annual
incidence rate of Shaken Baby
Syndrome is between 750 and 3,750.

• One third of the victims of SBS
survive with few or no consequences,
one-third suffer permanent injury and
one third die.

• Parental behaviors, environmental
factors and child characteristics all
may contribute to a shaking event
Adapted From: www.biausa.org
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Physical Abuse:

Adapted From: www.biausa.org
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Physical Abuse:

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Physical Abuse:

Adapted From: www.nytimes.com/.../9013Shakenbabysymptoms.html
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Physical Abuse:

Adapted From:
www.sacredpursuit.com/gpage9.html 49

Physical Abuse:

(A) This computerized tomography (CT) scan of the brain, obtained immediately following a shaking event, shows
significant cerebral edema. Due to brain swelling, the gray and white matter of the brain are unable to be
differentiated. The reddened areas signify fresh blood between the brain hemispheres.

(B) shows the same brain, scanned 3 months after the shaking event. The dark area shows areas of brain loss. The
child did not survive.

Reprinted with permission from Lauridson J, Levin A, Parrish R, Wicks A. 2002. Shaken Baby Syndrome: A Visual Overview. (Version
2.0) [Animated CD ROM], Ogden, Utah: The National Center on Shaken Baby Syndrome.

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Physical Abuse:

Adapted From: www.biausa.org 51

Physical Abuse:

Figure 5. The number of hours normal infants spent crying in the first 14 weeks of life. Note the peak at 6
weeks of age despite the wide range of distribution for all infants.

Reprinted with permission from The National Center on Shaken Baby Syndrome, & Barr, R. It is here…The Period of Purple Crying [Brochure];
The National Center on Shaken Baby Syndrome, Ogden, Utah; 2002.
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Physical Abuse:

Figure 6. This graph illustrates the relationship between early infant crying and the timing of Shaken
Baby Syndrome. The incidence of shaken baby syndrome peaks approximately 1month after the peak of
early infant crying.

Reprinted with permission from Barr, R.© Curves of early infant crying and SBS incidence. Proceedings of the Fourth National
Conference on Shaken Baby Syndrome; 2002 Sept 12-15; Salt Lake City, Utah.
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Physical Abuse:

Adapted From: www.biausa.org 54

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Physical Abuse:

Adapted From: http://gothamist.com/2006/10/27/brain_injured_b.php 55

Physical Abuse:

The Bottom Line:

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Medical Abuse
Medical child abuse occurs when a caregiver
fails to ensure that the child receives the
medical treatment that is necessary to
ensure their health. This may include:

•failure to ensure the child is up-to-date on
immunizations;

•failure to enroll the child in mental health
counseling if necessary for their mental well-
being, and;

•even not ensuring a child takes medicine
that is prescribed for their health;

•fabricating or creating an illness in a child
through the manipulation of medications or
by intentionally sabotaging treatment efforts.

Adapted From: http://safety.more4kids.info/177/signs-of-child-abuse/# 57

Medical Abuse:
Munchausen By Proxy Syndrome
Munchausen by Proxy Syndrome (MBPS) is a relatively uncommon condition that involves the
exaggeration or fabrication of illnesses or symptoms by a primary caretaker. One of the most harmful
forms of child abuse, MBPS was named after Baron von Munchausen, an 18th-century German dignitary
known for telling outlandish stories.

About MBPS
• In MBPS, an individual — usually a mother — deliberately makes another person (most often his or her own
preschool child) sick or convinces others that the person is sick.

• The parent or caregiver misleads others into thinking that the child has medical problems by lying and
reporting fictitious episodes.

• He or she may exaggerate, fabricate, or induce symptoms.

• As a result, doctors usually order tests, try different types of medications, and may even hospitalize the
child or perform surgery to determine the cause.

Adapted From: http://kidshealth.org/parent/general/sick/munchausen.html# 58

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Medical Abuse:
Reported Cases

• Children who are subject to MBPS are typically preschool age, although there have been reported
cases in kids up to 16 years old, and there are equal numbers of boys and girls. About 98%
of the perpetrators are female.

Diagnosing MBPS
Diagnosis is very difficult, but would involve some of the following:
• a child who has multiple medical problems that don't respond to treatment or that follow a
persistent and puzzling course physical or laboratory findings that are highly unusual, don't correspond
with the child's medical history, or are physically or clinically impossible short-term symptoms that tend
to stop when the perpetrator isn't around;

• a parent or caregiver who isn't reassured by "good news" when test results find no medical
problems, but continues to believe that the child is ill;

• a parent or caregiver who appears to be medically knowledgeable or fascinated with medical
details or appears to enjoy the hospital environment;

• a parent or caregiver who's unusually calm in the face of serious difficulties with the child's
health;

• a parent or caregiver who's highly supportive and encouraging of the doctor, or one who is angry
and demands further intervention, more procedures, second opinions, or transfers to more
sophisticated facilities

Adapted From: http://kidshealth.org/parent/general/sick/munchausen.html# 59

Medical Abuse:
What Happens to the Child?

• In the most severe instances, parents or caregivers with
MBPS may go to great lengths to make their children sick.
When cameras were placed in some children's hospital
rooms, some perpetrators were filmed switching
medications, injecting kids with urine to cause an
infection, or placing drops of blood in urine specimens.

• According to experts, common conditions and symptoms
that are created or faked by parents or caregivers with MBP
include: failure to thrive, allergies, asthma, vomiting,
diarrhea, seizures, and infections.

• The long-term prognosis for these children depends on the
degree of damage created by the perpetrator and the
amount of time it takes to recognize and diagnose MBP.
Some extreme cases have been reported in which children
developed destructive skeletal changes, limps, mental
retardation, brain damage, and blindness from
symptoms caused by the parent or caregiver. Often, these
children require multiple surgeries, each with the risk for
future medical problems.

Adapted From: http://kidshealth.org/parent/general/sick/munchausen.html#

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Medical Abuse:
Getting Help for the Child

If Munchausen by proxy syndrome is suspected, health care providers are required by
law to report their concerns. However, after a parent or caregiver is charged, the child's
symptoms may increase as the person who is accused attempts to prove the presence of
the illness. If the parent or caregiver repeatedly denies the charges, the child should be
removed from the home and legal action should be taken on the child's behalf.

In some cases, the parent or caregiver may deny the charges and move to another
location, only to continue the behavior. Even if the child is returned to the perpetrator's
custody while protective services are still involved, the child may continue to be a victim of
abuse. For these reasons, it's always advised that these cases be resolved quickly.

Getting Help for the Parent or Caregiver
Most often, abusive Munchausen by Proxy cases are resolved in one of three ways:

• the perpetrator is apprehended
• the perpetrator moves on to a younger child when the original victim gets old enough
to "tell"
• the child dies

Adapted From: http://kidshealth.org/parent/general/sick/munchausen.html#

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Medical Abuse:

Adapted From: http://gothamist.com 62

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Medical Abuse:

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Medical Abuse:

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Sexual Abuse

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Sexual Abuse
Man Sexually Abuses Toddler, Transports Kiddie Porn
Tuesday, June 22, 2010 Adapted from: Mensnewsdaily.com

Paul C. Marlowe, 21, of Chesterfield County, Virginia, was sentenced to close to 18 years (210
months) in federal prison on Friday for transporting child pornography, a sentence that was
enhanced because of Marlowe’s pattern of sexually abusing children and minors as young as 2
years old. “Every image in a child pornography case represents someone abusing a child,” said
U.S. Attorney Neil MacBride. “These are not just photos, and this case makes clear that those who
view these images may engage in abuse themselves. My office aggressively pursues these cases to
stop the abuse and take these predators off our streets.”

On January 20, 2010, Marlowe pled to two counts of transportation of child pornography. According
to court documents in the case — obtained by the National Association of Chiefs of Police – Marlowe
was identified by law enforcement officers during an undercover investigation of individuals trading
images of child sexual abuse over the Internet.

During their investigation, agents executed a search warrant at Marlowe’s residence where they
seized a computer. A subsequent forensic examination revealed e-mails sent to different individuals
from Marlowe’s AOL e-mail account with attachments containing numerous images of child
pornography, as well as dozens of additional images and videos of child sexual abuse saved on the
computer. Marlowe later admitted to agents to sending the e-mails.

During interviews conducted during the course of the investigation, Marlowe also admitted to
engaging in sexually explicit conduct with six children ranging in age from 2 to 14 years old. The
case was investigated by the Federal Bureau of Investigation and the Virginia State Police. Special
Assistant United States Attorneys Gene Fishel and Tommy Johnstone of the Virginia Attorney
General’s Office prosecuted the case on behalf of the United States 66

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Neglect & Maltreatment

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Adapted From: http://gothamist.com/2005/05/26/kids_in_a_parked_car_illegal.php
69

June 21, 2010 12:53 PM

Boy, 10, Found Hiding Under Sink from Fla. Parents
Accused of Torture; Cops Say Child Was Captive

PORT CHARLOTTE, Fla. (CBS/WTEV) Parents of a 10-year-old Florida boy
are charged with child abuse after police found the boy, who was reported missing,
under a bathroom sink, according to CBS affiliate WTEV.

The Charlotte County Sheriff's Office said Thomas Anthony Boone, 38, and Kimberly
Sue Boone, 39, each face three counts of aggravated child abuse for intentionally
torturing, cruelly punishing and unlawfully holding the child captive, reported
ABC's WZVN.

Charlotte County police began a search around 11 a.m. Saturday, after Thomas called
the Sheriff's office to report the boy missing. Five hours later with the help of search
dogs and helicopter units, authorities found the malnourished boy reeking of urine
under the master bedroom sink. The boy told investigators that he escaped from his
bedroom in search of food, then hid from his parents under the sink, said WZVN.

Investigators told WTEV that the couple held the boy captive in his bedroom where
authorities said he was forced to sleep on a urine-drenched bed and suffered
Thomas Boone (left); Kimberly Boone (right) malicious punishment. According to WTEV, he was only allowed to leave for school or
(Charlotte County Sheriff's Office) in the event that the family went away.

Thomas and Kimberly Boone were released after each posting each $15,000 bond.

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Frequently Asked Questions
New York State: Office of Children & Family Services
(OCFS) http://www.ocfs.state.ny.us/main/prevention/faqs.asp#supervision
At what age is it okay to leave my
children home alone?

 OCFS is often asked questions regarding
the appropriate age to leave a child alone,
or what age is appropriate to allow a child
to begin babysitting. There are no
straightforward answers to these
questions. All children develop at their
own rate, and with their own special needs
and abilities. Some children are
responsible, intelligent, and independent
enough to be left alone at 12 or 13 years
of age. Likewise, there are some teenagers
who are too irresponsible or who have
special needs that limit their ability to be
safe if they are left alone.

 Parents and guardians need to make
intelligent, reasoned decisions regarding
these matters

71

Frequently Asked Questions
New York State: Office of Children & Family Services
(OCFS) http://www.ocfs.state.ny.us/main/prevention/faqs.asp#supervision
Below there are some items for these
decision-makers to consider before leaving a
child alone. Be aware, this is just the
beginning of issues to consider. It is not an
all-inclusive checklist to guarantee
intelligent and reasoned decision-making:

 Consider the child: How mature is the
child? How comfortable is the child with
the circumstances? What has the child
done in the past to show you he/she is
able to take on this kind of responsibility?

 Consider the child’s knowledge and
ability: Does the child know how and
when to contact emergency help? Is the
child able to prepare food for him/herself?
Are there hazards to the child in the
environment such as accessible knives,
power tools, a stove or oven?

 Consider the circumstances: Where will
the child be when left alone? How long is
the child to be alone?
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Part IV:
Abuse Vs. Discipline
& Parenting Styles

73

Adapted From:
http://www.child-abuse-effects.com/abuse-and-discipline.html

Abuse Discipline

» Demonstrates anger and hostility. » Demonstrates love and affection.

» Make child listen. » Teach child right from wrong.

» Teach child that decisions are at the whim of the » Teach child to make healthy choices for him/herself
caregiver. and prepare child for eventual independence.

» Caregiver has all the power; child is given no » Based on a balance of power and mutual respect.
respect.

» Involves humiliation. » Does not involve humiliation.

» Requires submission. » Does not require submission.

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Adapted From:
http://www.child-abuse-effects.com/abuse-and-discipline.html

FACT: 94% of parents of toddlers reported using corporal punishment in the previous 12
months; 35% hit infants (Strauss, 2000, pp. 1109-11141).

FACT: In an American study, 28.4% of parents of two to four-year-olds and 28% of five
to eight-year-olds reported using an object to spank the bottoms of their children (Gallup
Survey). Thus more than one in four parents admit to using an object to hit their children
in the name of discipline (Gershoff, 2002, p. 602-6112).

* NOTE: In the all 50 states, parents are legally allowed to spank their children. But in 29
states it's illegal for a teacher to practice corporal punishment, including spanking.

In January, 2004, the Supreme Court of Canada upheld Section 43 of the Criminal Code, stating
parents had the right to spank their children without fear of being charged with a criminal offence.
But this spanking law has some new restrictions. The law now states that spanking is
permitted with children between the ages of 2 years and 12 years, that the use of weapons
like belts and paddles are prohibited, that strikes to the face and head are also prohibited,
and that only reasonable force can be administered. When discussing abuse and discipline, some
would argue that any physical force constitutes abuse, where others maintain that spanking falls
under the category of reasonable discipline.

While it is not suggested that others TELL parents exactly how to discipline their children, it is
strongly urged you help parents to make an informed decision by looking into alternative
forms of discipline.

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Adapted From:
http://www.nmha.org/go/information/get-info/strengthening-families/effective-discipline-techniques-for-
parents-alternatives-to-spanking

Effective Discipline Techniques for Parents: Alternatives to Spanking

Discipline vs. Punishment:

• Discipline is defined as a positive method of
teaching a child right from wrong. Punishment is a
form of discipline.

• Punishment may be physical--as in spanking, or
psychological--as in verbal disapproval, isolation or
loss of privileges. In some respects, punishment
represents one end of a very broad spectrum of
discipline techniques.

• Discipline is a tool to help children learn self-
control and take responsibility for their own
behavior. Children who are raised in a way that
stresses positive discipline will understand their
own behavior better, show independence, and
respect themselves and others.

• When punishment is the basis for discipline, the
person who punishes the child becomes
responsible for the child's behavior. 76

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Adapted From:
http://www.nmha.org/go/information/get-info/strengthening-families/effective-discipline-
techniques-for-parents-alternatives-to-spanking


Alternatives to Physical Discipline:
• Role Modeling. Most children learn behaviors by observing
their parents’ actions. Parents, therefore, must model the
ways they want their children to behave. Remember that if a
parent often yells, screams, or hits, the child will likely do the
same.

• Setting Rules. Rules should be reasonable, fair, realistic and
explained to child(ren) along with the consequences of not
following them. A minimum set of rules should be established
with attention given to the child’s age and developmental
level.

• Appropriate consequences allow a child to redeem
him/herself and relate to the misbehavior. A child should be
allowed to negotiate what the consequence will be; thus
building self-esteem and cooperation skills. Children may feel
less resentful and angry if they are allowed to help decide the
consequence of their negative behavior.

• Encourage and Reward Good Behavior. When children
are behaving appropriately, tell them so! Children can be
rewarded through tangible objects, privileges, increased
responsibility and verbal praise. 77

Adapted From:
http://www.nmha.org/go/information/get-info/strengthening-families/effective-discipline-techniques-for-
parents-alternatives-to-spanking

Alternatives to Physical Discipline:
• Creating Charts. Using charts to monitor and
reward behavior is an interactive way for a
child to learn appropriate behavior. A child’s
“progress chart” may create improved
cooperation and increased self-esteem. Charts
should be simple and used for one behavior at
a time with a designated time frame in mind.

• Time-Out. Time-out involves removing a child
from a situation following a negative behavior
as a means to calm down, establish control,
end inappropriate behavior, and reenter the
situation in a positive state. Effective time-outs
include an explanation of what the
inappropriate behavior is and why the time-
out is needed. The child should be told how long
the time-out will last and when it will begin. The
amount of time should be determined
based on the child’s age and developmental
level.

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Adapted From:
http://www.positiveparenting.com/graphics/promo/redirection_chart.gif

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Parenting Styles
In 1966, Diana Baumrind proposed a popular model of parenting styles.

"Baumrind believes that parents should be neither punitive nor aloof.“ Rather, they should develop rules for their
children and be affectionate with them. In her research she identified three main parenting styles in early child
development: authoritative, authoritarian, and permissive.

Baumrind's Model
Two key factors emerge in parenting style factor analysis:

• Demandingness: This relates to the demands the parents make on the child to be part of the family, their
expectations for mature behavior, the discipline and supervision they provide, and their willingness to confront
behavioral problems.

• Responsiveness: This relates to fostering individuality, self-assertion, and regulation, as well as being
responsive to special needs and demands.

Maccoby & Martin expanded the styles to four: authoritative, authoritarian, indulgent and neglectful. These
four styles of parenting involve combinations of acceptance and responsiveness on the one hand and
demand and control on the other.

These parenting styles are meant to describe normal variations in parenting, not deviant parenting, such as
might be observed in abusive homes. Most parents do not fall neatly in one category, but fall in the middle,
showing characteristics of more than one style

Adapted From: http://en.wikipedia.org/wiki/Parenting_style/Baumrind%27s_four_styles 80

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Parenting Styles

Adapted From: http://blogs.babble.com/strollerderby/wp-content/uploads/2009/10/parenting-style-300x210.gif 81

Parenting Styles
Types of Parents
Combining these two dimensions yields four kinds of parents; however, keep in mind that some of her
research is based mostly white middle class families and less on ethnic and lower SES families:

Authoritative: High Control and High Warmth
These parents fall in between the two types below, being flexible but firm, maintaining control and
discipline but showing some reason and flexibility as well, and communicating expectations but allowing
verbal give-and-take. They score as high on demandingness and responsiveness, and have clear
expectations for behavior and conduct which they monitor, and their discipline fosters responsibility,
cooperation, and self-regulation. Their children cope the best, are individuated, mature, resilient,
achievement oriented, self-regulated and responsible, and have the highest scores on tests of
cognitive competence. Children from single parent authoritative homes did not differ from two parent
authoritative homes, although girls from two parent homes showed greater functioning.

Authoritarian: High Control and Low Warmth
These parents are highly directive, value obedience and are more controlling, show less warmth
and nurturance and more distance and aloofness, and discourage discussion and debate. They are high
on demandingness but low on responsiveness, maintaining order, communicating expectations, and
monitoring the children carefully. Their children have a multitude of problems, and are less
individuated and show lower internalization of pro-social values, ego development, and perform
more poorly on cognitive tests and see their parents as more restrictive. They were also more
likely to come from divorced families. Boys from single authoritarian homes had more problems than
boys from two parent homes

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