Mandatory Reporting. Child Abuse.

ImageChild Abuse and Exploitation

As healthcare providers, especially in a pediatric world, we see and treat child abuse victims. We hear about it, we see, we treat, we comfort. Let’s see what are the numbers specifically for pediatrics? The horrifying truth is it is much more common then you think. According to recent statistics (RAINN.ORG)

  • 44% of victims are under the age of 18
  • 2/3 of all assaults are committed by someone known to the victim
  • Every 2 minutes another American is assaulted
  • Each year about 237, 868 individuals are assaulted
  • 60% of sexual assaults are not reported to the police
  • 38% of all rapes are either friends or an acquaintance

This is a difficult topic for anyone to discuss. After all, the question that plagues everyone is how can anyone do any type of abuse to a child. Let’s look at the numbers even more closely.

  • 15% of assault and rape victims are children under the age of 12
  • 7% of girls in grades 5-8 and 12% of girls in grades 9-12 said they had been sexually abused

  • 93% of juvenile sexual assault victims know their attacker

Keep in mind, these are numbers that have been reported, while many others have not been reported or the abusers have not been convicted and charges dropped. Child abuse and exploitation, it’s a horrific topic. It would be easier to turn the blind eye and say to ourselves this never happens. After all, these are children. It is one of the hardest things in my career and in my life, to treat and care for these children without wanting to cry and do all you can to protect them. After all, with healthcare in general, we decide to work in healthcare because we want to take care of others. As a pediatric nurse, our number one priority is the children we treat and care for.  As a nurse, I can speak of personal experience of treating and caring for these children.

As a professional we are mandated to report child abuse and neglect. 48 States including: the District of Columbia, American Samoa, Guam, The Northern Mariana Islands, Puerto Rico, and the Virgin Islands has a group of individuals listed who are required to report suspected child abuse or neglectful situations. Where as New Jersey and Wyoming do not list specific groups of individuals/professionals.

Individuals including: “Social workers, teachers and other school personnel, physicians and other health-care workers, mental health professionals, child care providers, medical examiners or coroners, and law enforcement officers. California, Connecticut, District of Columbia, Hawaii, Iowa, Illinois, Maine, Massachusetts, Nevada, Ohio, Vermont and Washington include coaches, camp/youth camp or residential camp personnel or owners, or recreational/sport program or facility personnel or administrators to report suspected child abuse or neglect” (

Abuse can occur within church systems, public, private schools, sporting groups and other public/private facilities. If abuse has occurred within a school system, church or any organization, many adults tend to overlook, to minimize, to explain away, or to disbelieve allegations of abuse. This is an act of denial (RAIN.ORG). This may be particularly true if the perpetrator is a family member or a friend.

Let’s review some warning signs.

Physical Signs (RAIN.ORG)
  • Difficulty walking or sitting
  • Bloody, torn, or stained underclothes
  • Bleeding, bruises, or swelling in genital area
  • Pain, itching, or burning in genital area
  • Frequent urinary or yeast infections
  • Sexually Transmitted Infections, especially if under 14 years old
  • Pregnancy, especially if under 14 years old
Behavioral Signs (RAINN.ORG)
  • Reports sexual abuse
  • Inappropriate sexual knowledge
  • Inappropriate sexual behavior
  • Nightmares or wetting the bed
  • Changes in appetite and either loosing or gaining dramatic amount of weight
  • Suicide attempts or self-harming, especially in adolescents
  • Seems threatened by physical contact, or shys away from any physical contact
  • Runs away
  • Very protective over siblings and assumes the protector role
  • Post-Traumatic Stress Disorder or Rape Trauma Syndrome symptoms

Common Reactions (

  • Shows sudden changes in behavior or
    school performance
  • Withdrawal
  • Depression
  • Sleeping & eating disorders
  • Self-mutilation
  • Comes to school or other activities early, stays late, and does not want to go home
  • Phobias
  • Psychosomatic symptoms (stomachaches, headaches)
  • School problems (absences, drops in grades)
  • Poor hygiene/excessive bathing
  • Anxiety
  • Guilt
  • Regressive behaviors – thumb-sucking, wetting the bed etc.
  • Additional information “What is Child Abuse and Neglect. Recognizing the Signs and Symptoms

So now the question is how can I help (

  • Listen and be there for the individual/child. Avoid being judgmental.
  • Be patient. Remember, it will take awhile for the individual to come to terms with the occurance.
  • Empower your loved one. During the occurrence of abuse, the individuals “power” is taken away from them. Encourage empowerment during this time.
  • If you are dealing with a situation that is involving a child, or your child. Give them a “safe” place and be a “safe” person to talk to.
  • If you suspect your loved one, or individual of suicidal thoughts, please get immediate medical attention. And continue to check in on the individual.
  • Most of all encourage the individual/loved one to report the abuse (call 911 in most areas). If our loved one has questions in regard to the process of criminal justice, talking with someone on the National Sexual Assault Hotline, 1.800.656.HOPE, can help.
  • Let your loved one know that professional help through various organizations.
  • If your loved one is willing to seek medical attention or report the assault, offer to accompany the individual wherever he or she needs to go (hospital, detectives office, police station, campus security, etc.)

If you suspect child abuse and/or neglect please contact your local authorities. Or if you have been assaulted or abused please contact the number below.

National Sexual Assault Hotline – 1.800.656.HOPE

Mandatory reporting of abuse and neglect

Here is a link of laws pertinent to your state. For additional information please look up your states statue of limitations and associated laws.

Laws in your state

Child Abuse and Sexual Abuse Resources:


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