11th January 23:23
Recognizing and reporting child abuse (stuttering personality crisis anxiety prognosis)
My daughter is enrolled in a local daycare center, and she's been acting anxious lately. Could something be wrong?
Yes. You have to respect your instincts, and if you suspect something is amiss at your daughter's daycare, you may well be right. But to put what you're feeling in perspective, consider that only about 3 percent of confirmed abuse in 1997 occurred in an out-of-home care setting like a daycare center, according to a recent report published by the National Committee to Prevent Child Abuse. That said, statistics offer little comfort if it's your child who may be at risk.
How do I know if my child has been abused ?
If your child spends any amount of time away from your care - whether he's with a babysitter or a relative, or at daycare or preschool - it's natural to wonder whether he's safe. And like any parent, you've probably wondered whether you'd be able to tell if your child was being mistreated. Of course, you can keep an eye out for physical symptoms and behavioral changes that may point to abuse, but it can be tricky figuring out exactly what's going on. "You're always playing a guessing game," says Kathy Baxter, director of the San Francisco Child Abuse Council. "A child could have many other reasons for acting out, being fussy, or becoming withdrawn. But parents are really good at knowing their children, so you have to try to put together a picture and go with your gut instinct."
If your child is old enough to talk, Baxter suggests regularly asking him questions such as, "Did anything happen to you today that you didn't like?" or "Have you ever been frightened at daycare?" If he's in the habit of telling you what makes him uncomfortable, he'll be more likely to tell you if anything is seriously amiss. "When it comes to abuse and neglect, most kids tell the truth," Baxter says. "But in most cases, they are reluctant. They don't want to get the person in trouble. They feel guilty; they feel it happened because they were bad."
If your toddler isn't talking well enough to tell you what's going on, pinpointing abuse can be even more difficult. What you can do is keep a close eye on your child for signs that all is not well. Some parents discover signs of abuse - such as internal bleeding and injuries - only when they take their child to a pediatrician because he won't stop crying or is excessively fussy. Here are some signals to watch for.
A child who has been physically abused may:
.. Cry and put up a fight when it's time to go to daycare, or appear frightened around the caregiver or other adults.
.. Come home with unexplained bruises, abrasions, burns, broken bones, black eyes, cuts, bite marks, or other injuries. Repeated injuries of any type can be a warning sign.
A child who has been emotionally abused may:
.. Display behavioral problems or changes such as shunning a parent's affections - or, alternately, becoming excessively clingy - or acting angry or depressed. Abused children often show extremes in behavior: A normally outgoing and assertive child may become unusually compliant and passive, while a generally mild child may act in a demanding and aggressive manner.
.. Become less talkative or stop communicating almost completely, or display signs of a speech disorder such as stuttering.
.. Act inappropriately adult or infantile. For example, a toddler may either become overly protective and "parental" toward other children, or revert to rocking and head banging.
.. Be delayed physically or emotionally, walking or talking later than expected or continuing to have regular temper tantrums. But since every child develops at a different rate, it can be difficult to determine whether a developmental delay stems from abuse.
.. Complain of headaches or stomachaches that have no medical cause.
A child who has been ***ually abused may:
.. Have pain, itching, bleeding, or bruises in or around the genital area.
.. Have difficulty walking or sitting, possibly because of genital or **** pain.
.. Suffer from urinary tract infections, or suddenly start wetting the bed.
.. Be reluctant to take off his coat or sweater, even on a hot day, or insist on wearing multiple undergarments.
.. Demonstrate ***ual knowledge, curiosity, or behavior beyond his age (obsessive curiosity about ***ual matters, for example, or seductive behavior toward peers or adults).
What should I do if I suspect my child has been abused?
Start by talking through your suspicions with your partner or a trusted relative or friend. Discussing your concerns will help you decide whether your child is just displaying normal behavioral variations or crying out for help. If your child is in daycare, talk to other parents who use the facility and ask them if they've noticed any unusual behavioral or physical symptoms in their children.
Then, difficult as it is to imagine, talk to the care provider in person. Bring along your spouse or another concerned parent or adult if you need the support. Baxter notes that many parents are reluctant to take this step for fear of what they'll find out. But the face-to-face talk is important because parents can hear the caregiver's explanation while observing her reactions.
Note whether the caregiver is able to explain your child's injury or unusual behavior to your satisfaction. Does she seem defensive? Is she concerned, or dismissive? "There's no typical response that you can really judge by," Baxter says, but an unusually hostile or angry reaction is a definite warning sign.
If the care provider is unable to allay your concerns, the next step is to report your suspicions. Look for a hotline number under "child abuse" in your phone book. Or try calling your local child protective services agency or the department of human services in your state, county, or city. If those offices are closed, you can report suspected abuse directly to a local law-enforcement officer.
After you make a report, a social worker or law-enforcement officer will contact you. He'll talk to you and your child about what happened. If you have not already had your child examined by a physician, the social worker can refer you to one, as well as to support groups and other community services.
If my child is abused, what kind of help will he need ?
A child who has been physically or ***ually abused will need immediate medical attention from a physician trained to recognize these types of abuse. A doctor can evaluate your child's physical and emotional well-being, provide any necessary treatment, and collect evidence that could be used in a future court case.
Beyond that, it's hard to say how much and what kind of help your child will need. Every child responds differently to abuse, depending on the kind of abuse, whether the perpetrator was a family member or a stranger, whether the abuse was a one-time or recurring event, and the child's own personality. Even a child who appears to show no distress may be hurt and suffering. Generally, abused children suffer a range of feelings, including anxiety, lack of trust, guilt, anger, fear, and embarrassment.
The most important thing parents can do is believe their child. He shouldn't be made to feel he has done something wrong. "The more supportive the parent can be for the child, the better the long-term prognosis," Baxter says. You will certainly be emotional and angry, but you can reserve that for your partner, a friend, or a support group. Your child needs you to be calm and reassuring. A child will be upset by too many anxious questions from his parent, whom she trusts to have all the answers.
The Childhelp National Child Abuse Hotline / Voices for Children at 800/4ACHILD (800/422-4553) provides crisis intervention and professional counseling in English and Spanish, as well as referrals to local social services groups that offer counseling. The National Domestic Violence Hotline at 800/799-SAFE (800/799-7233) can also refer you to resources in your community, including counseling, emergency services, and assistance in reporting abuse.
Realize that abused children - and their families - are likely to face emotional turmoil long after the abuse has ended. You and your child will benefit from a strong support system, whether you rely on relatives and friends or a support group specifically for abuse survivors.
.. How do I find a safe care provider once we've dealt with the issue?
Take your time and investigate your choices when looking for a caregiver. Interview childcare providers in person, ask plenty of questions, and visit daycare centers more than once at different times of the day. Make sure the facility is clean and safe. Look closely to see whether the kids are happy and whether interactions between them and caregivers are positive and respectful. Ask about the caregiver's policies on parent visits, discipline, and emergency situations.
Get the names and numbers of parents who are currently using the care facility and those who have used it in the past. Call and ask for their honest assessment of the caregiver's reliability, disciplinary practices, and responsiveness to their concerns. If their child is no longer attending the facility, ask why.
Ruth Neil, project coordinator for the National Resource Center for Health and Safety in Child Care says good care at a daycare center has two basic components: "Number one, the facility should be totally comfortable with the parent dropping in at any time to visit and the parent should feel comfortable with the provider. And number two, the child should be in a place where there is more than one care provider. Not as much abuse occurs in a center, where people can keep an eye on each other."
Each state has different requirements for licensing and conducting criminal background checks on childcare providers. The National Resource Center for Health and Safety in Child Care posts each state's regulations for health and safety in childcare facilities on its Web site. Or you can call 1-800-598-KIDS (800/598-5437) to get the number of the agency that determines the regulations in your state. In California, for example, childcare facilities are licensed by the state Department of Social Services; all it takes is a phone call to find out whether any legal actions have been taken against the caregiver you're considering.
If you don't already have a childcare facility in mind, your local Child Care Resource and Referral Agency can help you find good child care in your area
How do I make sure it doesn't happen again ?
The best insurance may be feeling absolutely confident in a caregiver's integrity. Many facilities are wooing parents with new technology including video-camera surveillance, which allows you to check on your child throughout the day.
But both Neil and Baxter emphasize that choosing a childcare provider is a "feel"-based decision. Baxter says that she often tells parents to go with their instincts. Even if they can't pinpoint what bothers them about a care provider or facility, it's not worth taking chances with their child's safety and well-being. Adds Neil, "The most important thing is to trust your own feelings - and those of your child."