_____________________________ Child Abuse Identification and Reporting: The Pennsylvania Requirement
CASE SCENARIOS
CONCLUSION Child abuse and neglect are considered significant social prob- lems with deleterious consequences. As noted, a system has been implemented in all 50 states to ensure the safety of chil- dren, with laws defining what constitutes abuse and neglect and who is mandated to report. Healthcare professionals, regardless of their discipline or field, are in a unique position to assist in the identification, education, and prevention of child abuse and neglect. There are three key components of child abuse: a child victim and an act or failure to act (or series of acts or failures) engaged in intentionally, knowingly, or recklessly. The basis for reporting suspected child abuse is having reasonable cause to suspect a child is a victim of abuse. A person who has reasonable cause to suspect a child is a victim of child abuse is not required to identify the type of abuse they are reporting when making a report. A mandated reporter must immediately make a report sus- pected child abuse to ChildLine if they have reasonable cause to suspect a child is a victim of child abuse under any of the following circumstances: • The mandated reporter comes into contact with the child in the course of employment, occupation, and practice of a profession or through a regularly scheduled program, activity, or service. • The mandated reporter is directly responsible for the care, supervision, guidance, or training of the child, or is affiliated with an agency, institution, organization, school, regularly established church or religious organization, or other entity that is directly responsible for the care, supervision, guidance, or training of the child. • A person makes a specific disclosure to the mandated reporter that an identifiable child is the victim of child abuse. • An individual 14 years of age or older makes a specific disclosure to the mandated reporter that the individual has committed child abuse. It is not necessary for a child to come before the mandated reporter in order for the mandated reporter to make a report of suspected child abuse. In addition, the mandated reporter is not required to identify the person responsible for the child abuse in order to make a report. A person who has reasonable cause to suspect a child is a victim of abuse does not have to consider the exclusions from child abuse in order to make a report of suspected abuse. A mandated reporter is presumed to have acted in good faith when making a report. It is the duty of all mandated reporters in the state of Pennsyl- vania to know their responsibilities and the laws that govern the reporting process. All reporters should adhere to the established laws and rules that govern child abuse reporting,
In the following case scenarios, consider if the case should be reported as possible child abuse in accordance with Pennsylvania law. A young girl, 2 years of age, is brought to the emergency depart- ment by her mother and stepfather for a scalp laceration. The girl is very quiet and appears listless and out of sorts. Her mother reports that she was injured when she fell onto a rock outside, but that the injury occurred when the girl was being watched by the stepfather. The girl undergoes assessment for traumatic brain injury, including assessment of function using the modified Glasgow Coma Score. The toddler is found to have mild impairment (a score of 13), and the follow-up test two hours later indicates normal functioning. The nurse notices that the toddler appears to be afraid of the stepfather, leaning away and crying when he is near her. The stepfather also appears to be easily frustrated with the child, saying that he does not know why she cries so much. Aside from the physical injury, which could be consistent with the reported accident, this patient has some signs of bodily injury (e.g., flinches easily or avoids being touched) that may give a provider rea- sonable cause to suspect abuse. If the provider caring for this patient suspects that the stepfather may have neglected or physically abused her, they should make a report to ChildLine, which would initiate an investigation. A boy, 13 years of age, is undergoing a routine physical exam with his family physician. The physician asks the boy if he is excited to start school in the next few weeks and how his baseball team is doing. The boy becomes quiet and states that he is nervous about an upcoming trip with his baseball team but does not give additional information. When asked directly, the boy says that he is uncomfortable with the new assistant coach, who watches pornography with them during out-of-town tournaments and supplies them with pornographic magazines. However, the boy states that he doesn’t think it’s a big deal and that “all of the other kids seem to really like it.” In this case, the physician should make a report to ChildLine. This would be classified as a CPS case, and an investigation would be conducted. A girl, 6 years of age, visits the school nurse complaining of a stomach ache. She is disheveled in appearance, with torn, dirty clothing and unbrushed hair. She reports being hungry, as she did not have dinner the night before or breakfast this morning. She also reports that she has been sleeping in a car with her mother since they moved out of their apartment last month. The signs in the case indicate poverty, not abuse. As such, a report should not be made to ChildLine. Instead, the patient and her family should be connected with available services and resources to assist in meeting their immediate needs.
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Book Code: DPA1525
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