Test Bank for Child Abuse and Neglect 3rd Edition by Monica McCoy & Stefanie Keen

TEST BANK

TEST BANK

Part I: Introduction/Purpose Chapter 1 Introduction Chapter 2 Risk Factors for Child Maltreatment Chapter 3 Mandated Reporting

Part II: Types of Abuse and Their Effects Chapter 4 Physical Abuse Chapter 5 Child Neglect Chapter 6 Psychological Maltreatment Chapter 7 Sexual Abuse Chapter 8 Fetal Abuse Chapter 9 Munchausen by Proxy Syndrome Chapter 10 Resilience

Part III: Legal Issues Chapter 11 Forensic Interviewing of Child Victims Chapter 12 The Legal System and Child Maltreatment

Part IV: What Happens Next Chapter 13 The Maltreated Child and Child Protective Services’ Response Chapter 14 Preventing Child Maltreatment

c. Reformation d. Industrial Revolution Answer: B 7. During which time period was the concept of original sin prominent along with the belief that children had souls and should not be put to death? a. Ancient Times b. Middle Ages c. Reformation d. Industrial Revolution Answer: C 8. Which of the following became the symbol for education during the late Middle Ages/Reformation? a. the slate b. the birch rod c. the feather d. the pen Answer: B 9. John Locke saw children as tabula rasa which means they were born a. evil b. good c. as blank slates d. ready to be adults with no need for education Answer: C 10. Which of the following men argued that children were born with an innate sense of right and wrong? a. Locke b. Rousseau c. Kempe d. Freud Answer: B 11. If a mother insists that her child is capable of growing up to be a good, moral being without punishment or even much guidance, her views are most consistent with those proposed by a. Locke b. Rousseau c. Kempe d. The religious leaders of the Reformation Answer: B

12.

Jordon believes that her son, Justin, is a little angel. She thinks that he has an innate understanding of morality and all she needs to do as his mother is stand back and let him blossom into an amazing, moral person. Jordan’s belief is most like that of: a. Freud b. Locke c. Rousseau d. Christian scholars Answer: C 13. It was not until that the U.S. Supreme Court upheld the Fair Labor Standards Act which limited child labor. a. 1922 b. 1941 c. 1953 d. 1960 Answer: B 14. When children were removed from “unsuitable” homes in the 1670s, the reason the homes were found lacking was that a. The children were being physically disciplined b. There was not enough food c. The children were not given enough attention/praise/love d. The parents were not instilling proper values Answer: D 15. The first professional to attempt to rescue Mary Ellen from a life of abuse was a a. Policeman b. Missionary c. Teacher d. Fireman Answer: B In the case of Mary Ellen, Henry Bergh spoke out on Mary Ellen’s behalf. Bergh was associated with which organization? a. The local church b. The police c. The Society for the Prevention of Cruelty to Children d. The Society for the Prevention of Cruelty to Animals Answer: D 16.

17. The first juvenile court was founded in a. 1899 b. 1910 c. 1923 d. 1947 Answer: A 18. Which Supreme Court ruling confirmed that states do have the right to interfere in family relationships in order to protect children? a. in re Gault b. McCoy v. Neville c. Prince v. Massachusetts d. Mary Ellen v. New York Answer: C 19. Whose landmark paper on the “battered child” spurred a dramatic increase in public awareness of the impact of physical abuse? a.

Freud b.

Watson c.

Kempe d.

Giovanni Answer: C 20.

The modern, scientific study of child maltreatment began in

a. The 1880s b. The 1920s c. The 1960s d. The 1980s Answer: C 21.

The first Federal Law regarding child maltreatment were passed in

a. The 1950s b. The 1960s c. The 1970s d. The 1980s Answer: C 22. Which research design relies on people remembering and reporting past events? a. Longitudinal b. Experimental c. Correlational d. Retrospective Answer: D

True/False 1. The Society for the Prevention of Cruelty to Animals existed BEFORE The Society for the Prevention of Cruelty to Children.

Answer: True 2. The first Federal Law about Child Abuse was passed in 1974.

Answer: True 3. It is possible to make cause and effect statements based on a well-designed correlational study.

Answer: False Short Answer Questions: 1. Explain the saying, “Spare the rod and spoil the child.”

Answer: It was believed during the Reformation that children were born sinful and needed to be disciplined in order to develop as moral beings. The concern was that if a child was not beaten, they would behave in immoral ways. Therefore, parents and guardians were urged to use the rod so the child would not be ruined.

2. Children under the age of 14 years old are generally not permitted to work in the United States. List two exceptions to this rule.

Answer: Any two of these: acting, newspaper delivery, some types of family business.

3. List 2 reasons why it is better to be a child today than it was during the Industrial Revolution.

Answer: Any two of these: even very young children were forced to work long hours; working conditions were horrible/dangerous; children were exposed to occupational hazards causing injury and disease; children who were harmed or killed were labeled as “careless” 4. What occurred in the case In re Gault (1967) and what impact did it have on the juvenile court system?

Answer: In re Gault (1967) a 15-year-old boy was found guilty of making lewd remarks on the phone. He was sentenced to 5 years in a state industrial school – a far harsher penalty than an adult would have received for the same crime. As a result of this case, it was noted that the juvenile court was not working to help children as it was designed.

After this children in juvenile court were granted due process rights.

5. Define parens patriae.

Answer: Parens patriae translates as “father of his country.” It asserts that the stated is the ultimate guardian for children and the mentally incompetent.

6.

List 5 problems associated with research on the consequences of child maltreatment.

Answer: Any 5 of these: lack of appropriate control groups; based only on identified children; use of retrospective designs; often mix types of maltreatment; effects of maltreatment might not be immediately obvious; abuse is often confounded with poverty; abuse if often confounded with other family dysfunction; inability to make causal statements; lack of clear definitions; secrecy surrounding maltreatment

Video Suggestions for Chapter 1 1. Consider searching the internet for recent coverage of local child maltreatment videos. You can also search the video archives of local stations. Seeing real, recent, local cases makes the subject very relevant to students.

2. The 7:25 minute video clip entitled The Case of Mary Ellen Wilson was produced by the Army Community Service Family Advocacy Program and was uploaded on April 6, 2011. It is available on youtube: http://www.youtube.com/watch?v=bygP_su1o_g&oref=http%3A%2F%2Fwww.y outube.com%2Fwatch%3Fv%3DbygP_su1o_g&has_verified=1 3. The 56:35 minute video clip entitled The Disturbing True Story of a Little Girl’s Terror that Led to Child Protection by the Museum of the City of NY, covers the Mary Ellen case in detail. It was uploaded July 2, 2016. It is available on youtube: https://www.youtube.com/watch?v=zg5Ewr5cYjo 4. This 2:39 minute video clip is entitled, American Society for the Prevention of Cruelty to Children. It was uploaded Nov. 21, 2011. It is a public service announcement designed to bring attention to the problem of child abuse in America. It is available at http://www.youtube.com/watch?v=vO5oM0X90Lw 5. Fingers to the Bone: Child Farmworkers in the United States, was produced by Human Rights watch and uploaded on May 3, 2010. It explores the child labor laws in light of farm work. It is available at http://www.youtube.com/watch?v=NfEtO00DSvI 6. This very brief video clip (57 seconds) describes Locke’s concept of tabula rasa.

The clip, entitled Locke’s ‘Tabula Rasa’ was uploaded on Jan. 7, 2010. It is available at http://www.youtube.com/watch?v=E3CxgWqgaBE

Discussion Topics for Chapter 1 1. Have each student bring in a research article on child maltreatment. Ask the student to discuss strengths and weaknesses in the research design.

2. Ask students to bring in a news article about a local, recent case of child maltreatment. Put students who bring in the same case in a small group to work together. Have them summarize the facts of the case. As you work through the course, have them follow up with their case – identifying mandated reporters in the child’s life, risk factors, type(s) of maltreatment, and intervention.

Chapter 2 – Risk Factors for Child Maltreatment

Test Items: 1. One risk factor for child maltreatment is large family size. According to the Ecological Systems Theory, this is a problem in the a. Microsystem b. Mesosystem c. Exosystem d. Macrosystem e. Chronosystem Answer: A 2. Brad’s job is extremely demanding. As a result he is rarely at home while his son is awake. If this results in emotional neglect, which system in the Ecological Systems Theory led to the neglect? a. Microsystem b. Mesosystem c. Exosystem d. Macrosystem e. Chronosystem Answer: E 3. Some child care advocates worry that the coronavirus pandemic of 2020 likely led to an increase in child maltreatment. If this was the case, which system in the Ecological Systems Theory led to the new maltreatment cases? a. Microsystem b. Mesosystem c. Exosystem d. Macrosystem e. Chronosystem Answer: E 4. Females are more likely than males to be perpetrators of a. Sexual abuse b. Neglect c. All forms of abuse d. None of the above Answer: B

5. Males are more likely than males to be perpetrators of a. Sexual abuse b. Neglect c. All forms of abuse d. None of the above Answer: A 6. When state officials report which factors are most strongly linked to child maltreatment, they say: a. Family size and maternal depression b. Child factors and parental substance abuse c. Parental substance abuse and poverty d. Poverty and parental mental illness Answer: C 7. Concern about maternal depression is heightened because a. it nearly always involves psychosis b. it is more common in females and in during prime child bearing ages c. it is extremely rare, so we know little about it d. it always leads to child maltreatment Answer: B 8. Which of the following is not associated with increased risk for maltreatment? a. Young maternal age b. Low maternal educational level c. Lack of knowledge about child development d. All of the above are risk factors Answer: D 9. Which of the following is true about the intergenerational transmission of abuse? a. Nearly all children who are maltreated go on to maltreat their children b. Approximately 50% of children who are maltreated go on to maltreat their children c. A third or less of children who are maltreated go on to maltreat their children d. Almost no children who are maltreated go on to maltreat their children Answer: C 10. According to Ney (1989), the highest rate of intergenerational transmission is seen for a. Verbal Abuse b. Physical Abuse c. Physical Neglect d. Sexual Abuse Answer: A

11. According to Ney (1989), the lowest rate of intergenerational transmission is seen for a. Verbal Abuse b. Physical Abuse c. Physical Neglect d. Sexual Abuse Answer: C 12. Which of the following children would be at the greatest risk of being maltreated? a. One who lives with her married, biological parents b. One who lives with a single parent c. One who lives with a single parent and their partner d. They would all be at approximately the same risk for maltreatment Answer: C 13. Which of the following children would be at the greatest risk of being maltreated? a. An only child b. One of two children in the family c. One of three children in the family d. One of four or more children in the family Answer: D 14. Approximately of families with documented intimate partner violence also involved child maltreatment. a. 10% b. 25% c. 40% d. 55% Answer: C 15. Poverty seems to be correlated with the greatest increase in the risk of a. Physical abuse b. Neglect c. Sexual abuse d. Poverty does not increase the risk for maltreatment Answer: B

16. With regard to parental employment status, which group is associated with the highest risk for child maltreatment? a. Parents who are unemployed b. Parents who are employed c. Parents who are not in the work force d. Parental employment status is not a risk factor for child maltreatment Answer: C 17. In research on military families, there seems to be a significantly reduced risk of as compared to civilian families? a. Neglect b. Physical Abuse c. Sexual Abuse d. No forms of maltreatment showed a reduced risk Answer: A

True/False: 1. If a child lives in a poor environment and is being raised by a single parent, we know he will be maltreated.

Answer: False 2. If a child has a developmental delay, they are at an increased risk for child maltreatment.

Answer: True 3. A parent with a history of substance abuse who is now completely sober is at increased risk of maltreating their child.

Answer: True 4. Most people who maltreat their children can be diagnosed as having a psychological disorder.

Answer: False 5. Neglectful parents have less knowledge about children and child development than do non-neglectful parents.

Answer: True 6. The majority of maltreated children do not go on to maltreatment their children.

Answer: True 7. Children from low income families are more likely to be seriously injured by abuse than are children from families with higher incomes.

Answer: True

8. Female perpetrators are associated with fatal or near fatal abuse more often than are male perpetrators.

Answer: False Short Answer Questions: 1. Why are young children at greater risk for child maltreatment than older children?

Answer: Young children are more dependent on caregivers, it is normative in our culture to use physical force against young children, they are more likely to be injured to do small size and lack of strength, and they have more difficulty regulating their emotions.

2. List 3 reasons that maltreated child may grow up to become an abusive parent.

Answer: 1. They are doing what they know; what they learned by observing their parent. 2. The maltreatment they suffered may have caused them to have problems with attachment or empathy or making social connections. 3. They are more likely to become substance abusers than are non-maltreated children and this increases risk for maltreatment.

3. If you were investigating a possible case of child maltreatment list a child factor, a parental factor, a family factor and an extra-familial factor that would make you more concerned about the situation.

Answer: Many possible answers. For example: a child who was disabled, a parent who was depressed, a family with 4 or more children and a family that was socially isolated.

4. What might explain why maltreating families tend to be socially isolated?

Answer: The families may be more transient than other families; the maltreating family may be attempting to hide their behavior; others may avoid maltreating families because they are abusive; or maltreating mothers may only reach out to others who are facing similar struggles and who are not available to be supportive.

5. List 3 risk factors and 3 protective factors associated with military families.

Answer: For protective factors, any 3 of these: - Military personnel are screened for history of mental illness - Military personnel are screened for criminal history - Low rate of illegal drug use in military - At least one parent is employed - Minimum education requirement must be met - Have health care - Have access to support programs For risk factors, any 3 of these: - Young parents - Young children - More parents with a history of child maltreatment

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Increased rates of alcohol abuse Increased rates of criminal domestic violence Isolation Reduced access to Child Protective Services if stationed outside of the U.S. Deployment

Video Suggestions: 1. Bastard out of Carolina is a 101 minute movie that follows the life of an illegitimate child, Ruth Ann, growing up in the 1950s in South Carolina. Ruth Ann, nicknamed “Bone” is the victim of severe physical and sexual abuse. As students watch the film, encourage them to note what risk factors were present in Ruth Ann’s life. Child factors, parental factors, family factors, and community factors are all evident.

WARNING: This film contains graphic scenes of physical abuse and sexual abuse including the violent rape of a young girl. It is rated R.

Bastard Out of Carolina (1996). Produced by Showtime Networks. Directed by Anjelica Houston. Based on the semi-autobiographical novel of the same name by Dorothy Allison. ISBN 1-57252-680-7 2. This short video (1:12 minutes) is available on youtube at http://www.youtube.com/watch?v=VQnRQgGYyic It is an anti-violence and substance abuse ad. It won first prize for the Cammi Awards sponsored by Weber Human Services. It was uploaded November 27, 2009.

3. The Child Abuse Prevention Center in California produced this 6:56 minute video clip entitled Inspire. The video was uploaded March 22, 2011 and can be found at http://www.youtube.com/watch?v=h9yf2LSeXQI. The video focuses on addressing risk factors through education and community intervention. This video could also be used when covering prevention.

4. This public service announcement is available at http://www.youtube.com/watch?v=5veGr2J57rs. The title is Drug Addicted Parents and Child Abuse. The video is 2:22 minutes and gives an emotional account of parental substance abuse from the point of view of a male, teenager.

5. This ABC news clip covers the case of two women (a mother and grandmother) charged with neglect of 2-year-old twins and sentenced to 5 years in prison. The women’s claims of lack of knowledge and mental illness did not sway the judge to be lenient. The 2:30 minute clip was uploaded on April 27, 2011 and can be found at http://www.youtube.com/watch?v=heG8Drb30fY.

6. This Medscape clip features Arthur L. Caplan, Ph.D. of the NYU School of Medicine. His short talk (3:52 minutes) focuses on medical ethics in response to a study in New Zealand that measured risk factors for maltreatment. Dr. Caplan argues that creating predictive formulas raises a host of moral questions about issues of privacy, and whether forecasting is appropriate if it is not tied directly to prevention. This clip was uploaded on March 23, 2018. https://www.medscape.com/viewarticle/893821 7. An in depth look at domestic violence and child abuse in the military is presented in this podcast sponsored by C-SPAN. The podcast runs 1:51:51. A panel of survivors and advocates discuss their experiences and make recommendations.

Then, a panel of clinical professionals and a Defense Department official discuss the issues and make recommendations. The podcast was uploaded on March 8, 2018 and can be found at https://www.c-span.org/video/?442268-1/hearingfocuses-domestic-violence-child-abuse-military Discussion Topics: 1. Have your students watch an episode of a reality television show that involves parents/parenting. Have them identify risk factors and protective factors that are evident in the child’s environment.

2. For each potential risk factor, discuss how easy or challenging it would be for a social worker to notice or measure it. Are there factors that are more or less likely to be misinterpreted by a social worker?

3. How might we convince parents who face many risk factors to accept help or intervention before they maltreat their child(ren)?

4. Instruct students to find a case of child maltreatment that was covered in the news. What risk factors were evident in the child’s life?

Chapter 3 - Mandated Reporting Test Items: 1.

States first adopted mandated reporting laws for child maltreatment in the a. 1940s b. 1960s c. 1980s d. 2000s Answer: B 2.

In what year were all states required to list mandated reporters, provide immunity for those who report in good faith, and ensure reporters confidentiality in order to receive Federal Aid? a. 1967 b. 1974 c. 1982 d. 1993 Answer: B 3.

Originally, only a. Psychologists b. Lawyers c. Police Officers d. Physicians Answer: D

were listed as mandated reporters.

4.

If you are not a mandated reporter, but you suspect a child is being maltreated, a. the law does not allow for you to report b. you have to report to avoid legal consequences c. you are allowed to report as a permissive reporter, but there is no legal mandate to do so d. none of the above are true Answer: C 5.

The issue of mandated reporting can be complicated for persons conducting research in the area because informed consent guarantees a. confidentiality b. that there is no risk involved in the research c. that any suspected maltreatment will be reported d. the researchers are not mandated reporters Answer: A

6.

Child abuse reporting laws require that a report be made when you have: a. reasonable cause to believe maltreatment has occurred b. strong evidence of child maltreatment c. at least one witness to the abuse Answer: A 7.

Kathryn, a mandated reporter, must report child maltreatment when she has a. conducted an investigation and knows the child has been abused b. reasonable cause to believe the child has been abused c. several types of evidence pointing to abuse (child’s testimony, physical evidence, and corroborating evidence) d. A vague feeling that something is not right with the child Answer: B 8.

If a mandated reporter fails to report suspected child maltreatment, the most likely outcome is that a. they have not done anything legally wrong, but they are at fault morally. b. they are guilty of a felony. c. they are guilty of a misdemeanor. d. they cannot be sued for malpractice.

Answer: C 9.

Mandated reporters who are found guilty of failure to report suspected child maltreatment can a. Be fined b. Be sent to jail c. Both A and B d. Neither A nor B Answer: C 10.

Kayla is not a mandated reporter, but she strongly suspects that her neighbor is abusing her child. If Kayla makes a report, she is a(n) a. Mandated reporter b. Anonymous reporter c. Permissive reporter Answer: C 11.

What was the ruling in the Landeros v. Flood case where a physician was charged with failure to report child maltreatment? a. Not guilty by the trial court and guilty by the California Supreme Court b. Guilty by the trial court and not guilty by the California Supreme Court c. Not guilty by both courts d. Guilty by both courts Answer: A

12.

With regard to training in child maltreatment a. All mandated reporters say that this was a significant part of their education b. Most reporters say there is no need for ongoing training once they begin working c. Most mandated reporters say their training was minimal or inadequate d. Most reporters feel very well versed on the legal aspects of reporting Answer: C 13.

Nurses seem most comfortable reporting suspicions of a. Emotional abuse b. Neglect c. Munchausen Syndrome by Proxy d. Physical abuse Answer: D 14.

According to Morelen and Shafer (2012), which type of maltreatment requires special attention in training programs if mandated reporters are to be skilled at recognizing it and reporting it? a. Physical Abuse b. Emotional Abuse c. Sexual Abuse d. Neglect Answer: B 15.

The substantiation rate for child maltreatment reports in the United States is around: a. Less than 33% b. Close to 50% c. Nearly 75% d. Almost 100% Answer: A 16.

In what percentage of child maltreatment cases is the case brought to the attention of the authorities by the child being maltreated? a. 0.5% b. 10% c. 15% d. 20% Answer: A

True/False 1.

Mandated reporting laws have not significantly increased the number of reports made to CPS. Answer: False 2.

If a mandated reporter makes a report of child maltreatment in good faith, they are immune from criminal liability.

Answer: True 3.

In most states lawyers are not legally obligated to report cases of suspected child maltreatment.

Answer: True 4.

Because of doctor/patient confidentiality laws, a psychologist is not legally obligated to report cases of suspected child maltreatment.

Answer: False 5.

Black children are reported to CPS at a rate that is twice as high as the rate for white children.

Answer: True 6.

Universal Mandated Reporting leads to a dramatic increase in the number of cases reported.

Answer: False

Short Answer Questions: 1. If a mandated reporter suspects child maltreatment, who should they report their suspicions to in order to fulfill their legal obligation?

Answer: You report suspected cases of child maltreatment to your local child protective services agency, your state abuse hotline or the local police 2. What information should you be prepared to report when you report suspicions of child maltreatment?

Answer: Give as much detailed information as possible. Include the child’s name and location. Provide the name of the alleged perpetrator if known as well as their relationship to the victim. Then, report specifically what you have seen and/or heard that led to your suspicions.

3. Although anonymous reporting is permitted, list three reasons why it might not be in the best interest of the child.

Answer: First, an anonymous call may not be taken as seriously as a call in which the reporter leaves their name. Second, if you do not leave your name and contact

information, a social worker cannot get in touch with you for follow-up questions. Third, if you are a mandated reporter, there is a not a clear record that you have fulfilled your reporting duty.

4. Why might a professional fail to make a mandated report of child maltreatment?

Answer: Some professionals do not report because they are not confident the report will help the child. Others state that previous contact with CPS was not helpful. Professional counselors may resist reporting out of a desire to protect the therapeutic relationship they have with their client. Finally, many reporters lack the necessary knowledge to be confident reporters.

5. Why might mandated reporting laws NOT be a good thing?

Answer: Mandated reporting laws may not work at preventing the most serious forms of maltreatment. The incidence of child fatalities due to maltreatment has not changed since the mandated reporting laws went into effect. Also, the costs of mandated reporting may outweigh the benefits. Mandated reporting may do more to increase the number of reports and investigations than it does to increase the number of children helped.

Video Suggestions 1. Recognizing Child Abuse (2007). This 26 minute dvd presents information on the reality of child abuse, the consequences of abuse, and recognizing and reporting maltreatment.

It is produced by Meridian Education and available at many academic libraries (check World Cat for listings: http://worldcat.org/identities/lccnn86111247/) or it can be purchased at https://films.com/id/12798/Recognizing_Child_Abuse.htm for $89.95.

2. The 10:26video, Mandated Reporting Training - Child Protection Response was posted on September 27, 2018 by the Minnesota Department of Human Services. It covers what information a mandated reporter should be prepared to provide when they call and what steps the local child welfare agency is likely to take following the call. I can be found at: https://www.youtube.com/watch?v=NroHE__saG8 3. There are many videos online of the victims of Larry Nassar. NBC News posted over 3 ½ hours of statements that streamed live on Jan. 19, 2018.

Those are available here: https://www.youtube.com/watch?v=2WUEmrBG6Zc Some of this testimony is graphic and may be upsetting to viewers.

4. This 1:55 minute video clip is available on youtube. The clip, Catholic Church Official Convicted in Sex Abuse Cover Up, reviews the conviction of a priest for shield predators by moving them to other congregations. http://www.youtube.com/watch?v=mMF0pHzX9oA

5. This 2:22 minute video clip is available on youtube. The clip, Child Abuse Reporting, was uploaded on Dec. 5, 2011 by Washington State DSHS. The clip covers how reports come in to DSHS and how they are handled. It can be found at http://www.youtube.com/watch?v=MVfaKD37SQk 6. This 3:06 minute news clip addresses some of the concerns about child maltreatment raised by the coronavirus pandemic of 2020. The video was posted on April 6, 2020 and deals with cases in SC covering decreases in reporting, increased parental stress and increased financial instability along with sharp decreases in interactions with mandated reporters. https://www.live5news.com/2020/04/06/sc-dss-child-abuse-reports-downduring-pandemic/ 7. This 1:42 second clip from Spectrum News presents the case of a school supervisor who was charged with child neglect after failing to report a case of physical abuse. https://www.baynews9.com/fl/tampa/news/2020/02/18/school-supervisorcharged-for-failing-to-report-child-neglect#

Discussion Topics 1. The question of whether clergy should be mandated reporters of child maltreatment is one that people feel passionately about. Encourage students to discuss this issue in light of the separation of church and state. You may also want to have students discuss what, precisely, is meant by confidentiality between a minister and a parishioner. Rev. Marie M. Fortune differentiates between secrecy (a promise to never tell) and confidentiality. She writes, “Confidentiality means to hold information in trust and to share it with others only in the interest of person involved, i.e., with their permission, in order to seek consultation with another professional, or in order to protect others from harm by them” (p. 2). She adds, “confidentiality is not intended to protect abusers from being held accountable for their actions or to keep them from getting the help that they need (p. 2).

Fortune, M. (1985). Confidentiality and mandatory reporting: A clergy dilemma?

Working Together, 6(1), 1-6. https://www.faithtrustinstitute.org/resources/articles/Confidentiality-andMandatory-Reporting2014.pdf 2. An interesting question for debate is whether or not researchers should be mandated reporters for child maltreatment. Students can read the ethical essay by Allen (2009) and argue for and against requiring researchers to be mandated reporters. (Note: this article does conclude that researchers should be mandated to report, so it will be easier to argue that position based on this article.)

Allen, B. (2009). Are researchers ethically obligated to report suspected child maltreatment? A critical analysis of opposing perspectives. Ethics and Behavior, 19(1), 15-24. https://doi.org/10.1080/10508420802623641 3. If your students are up for tackling a particularly complex issue, you may ask them to discuss whether psychologists or psychiatrists who are doing a court ordered evaluation of person who is being charged criminally (with a crime unrelated to child maltreatment) should be required to report suspicions of maltreatment that arise during their assessment. While psychologists and psychiatrists are mandated reporters, it is not clear if this type of interaction is covered by the attorney client privilege. Kapoor and Zonana (2010) provide an excellent review of the issue and present arguments for and against mandated reporting in cases like this.

Kapoor, R., & Zonana, H. (2010). Forensic evaluations and mandated reporting of child abuse. Journal of the American Academy of Psychiatry and Law, 38, 49-56.

4. Henderson (2013) provides a two page case example examining how a counselor might handle mandated reporting within a therapeutic context at the end of her article: Henderson, K. L. (2013). Mandated reporting of child abuse: Considerations and guidelines for mental health counselors. Journal of Mental Health Counseling, 35(4), 296–309. https://doi.org/10.17744/mehc.35.4.x35610245863n034 5. In the third edition, I replaced the Penn State University case with the Larry Nassar case. However, if you are interested in covering the Penn State case, I include that here: Recently, the nation was shocked by allegations that Jerry Sandusky (JS), a former defense coordinator at Penn State University had sexually abused more than 10 boys over a 15-year period. Furthermore, it came to light that the beloved coach, Joe Paterno, had known of some of the alleged incidents and had not involved the police. Although JS has pled “not guilty” to the allegations, he was arrested on December 7, 2011 and charged with 52 counts.

As the grand jury prepared the case, it became clear that numerous persons, including many educated professionals and mandated reporters, had known of the alleged inappropriate behavior and had failed to make a report to the proper authorities. Although in many cases people will say they did not report because they were not sure what they saw was abusive, that is not a plausible excuse for all witnesses in this case. In 2000, Jim Calhoun, a janitor, says he saw JS perform oral sex on a boy who was pinned against a wall in the locker room. Although this witness told other janitors and his supervisor, it was not reported to authorities.

Others had suspicions and did not feel sure enough to report. Both the assistant

principal and a teacher at a high school where JS volunteered were uncomfortable with the relationships JS had with the boys, but neither reported. When a graduate student, Mike McQueary, allegedly saw JS anally assault a young boy in 2002, he did report to Joe Paterno who, in turn, reported to the athletic director. At this point, JS was asked to give up his key to the locker room and the people in charge of The Second Mile (a program started by JS to help at-risk children) were informed. However, the police were not notified.

Moreover, when allegations were reported, they were not acted on appropriately.

In 1998, a mother called the police at Penn State to report that her 11-year-old son told her that JS showered with him and hugged him repeatedly. Although JS admitted that he showered with this boy and others and even said, “I wish I were dead,” no criminal charges were filed. In 2009, a mother called a high school and alleged that her son was sexually abused by JS. The school banned JS from their campus, and the school officials notified the police. This, after more than a decade of failed reporting and poor investigation, led to a full investigation. The criminal trial began on June 11, 2012.

Although people are arguing in the legal arena about who knew, or who suspected, what at what time, it seems clear that the community let children down.

Not only were early victims not helped promptly, the appropriate steps were not taken to prevent future victims. Before his death from lung cancer at the age of 85, Joe Paterno said, “This is a tragedy. It is one of the great sorrows of my life.

With the benefit of hindsight, I wish I had done more” (Chappell, 2012; Vieth et al., 2012). On June 22, 2012, a jury returned a verdict of guilty on 45 of 48 counts (4 charges were dismissed by the judge during the trial: 2 were unproved, 1 was brought under a statute that did not apply, and 1 was duplicative). The most serious charges for Victims 2, 5, and 6 resulted in the not-guilty verdicts, but Sandusky was found guilty of the most serious charges, including involuntary deviate sexual intercourse, for other victims (Scolforo & Armas, 2012). On October 9, 2012, Sandusky was sentenced to prison for 30 to 60 years. This means he will not be eligible for parole until he is 98 years old. Sandusky continues to say he is innocent.

DISCUSSION QUESTIONS A. Is it more difficult to make allegations if the alleged perpetrator is seen as a “pillar of the community”? If so, what can be done to help children who may be victims of perpetrators who present as upstanding citizens?

B. Do we take the sexual abuse of boys more lightly than the sexual abuse of girls? Is this true even if the alleged perpetrator is male in both cases?

C. Is there ever a situation where a grown man showering naked with young boys would be appropriate, or should such behavior always be considered abusive?

D. In response to the sexual abuse scandal at Penn State University, the National Collegiate Athletic Association (NCAA) made the following sanctions: - 60 million dollar fine - Vacated 112 wins (1998-2011) - Four year post-season ban - Four year scholarship reduction - Allowed players to transfer and play immediately at other schools - Instituted a five year probation for the athletic department Have the students discuss these sanctions. Are they fair? Do they punish the right people? Are more innocent people hurt by these sanctions? Will these sanctions work to make other schools more responsive to allegations of sexual abuse? If these sanctions are not appropriate, what would have been a better response?

This 4:59 minute video clip is available on youtube. The clip, Jerry Sandusky Trial Verdict: Former Penn State Coach Guilty on 45 Counts, originally aired on June 23, 2012. http://www.youtube.com/watch?v=CTiswy3vnkQ

Chapter 4 – Physical Abuse Test Items 1. When defining child physical abuse a. All states include only harm; not risk of harm b. All states include both harm and risk of harm c. Some states include only harm; some states include only risk of harm d. All states include harm; some also include risk of harm Answer: D 2. You read a report that tells you there were 323,000 cases of child physical abuse in 2006 under the harm standard. This is providing you with data about the of abuse. a. incidence b. prevalence c. incidence and prevalence d. none of the above Answer: A 3. You read a research study that says 28% of adults surveyed had experienced child physical abuse. This is providing you with data about the of abuse. a. incidence b. prevalence c. incidence and prevalence d. none of the above Answer: B 4. Approximately what percentage of cases handled by DSS are about physical abuse? a. 10.1% b. 22.7% c. 37.6% d. 54.8% Answer: B 5. Robert is beaten so badly by his step-father that he is intensive care. This abuse would be categorized as a. Fatal b. Serious c. Moderate d. Mild Answer: B

6. Joann’s arm was broken by her mother. Her abuse would be categorized as a. Fatal b. Serious c. Moderate d. Mild Answer: B 7. Brad was spanked so hard by his father that he had red marks on his buttocks for two days. His abuse would be categorized as a. Fatal b. Serious c. Moderate d. Mild Answer: C 8. Which of the following is a positive outcome of corporal punishment? a. Internalization of morality b. Immediate compliance c. Lower rates of aggression d. Better relationship between parents and child Answer: B 9. Which of the following statements is true regarding research findings on corporal punishment? a. It is associated with more positive outcomes than negative outcomes. b. It is associated with more negative outcomes than positive outcomes. c. It is associated with an equal number of negative and positive outcomes.

Answer: B 10. When assessing bruises on a child, you should consider a. the placement of the bruises b. the color of the bruises c. the age of the child d. all of the above Answer: D 11. Which of the following bruises is likely to be the oldest? a. a red one b. a black/purple one c. a yellow one d. you cannot tell by color Answer: C

12. Which bruise location is most concerning when assessing for abuse? a. a bruise on the shin b. a bruise on the elbow c. a bruise on the back d. a bruise on the forehead Answer: C 13. Fractures are the most suspicious if seen in a a. 6-month-old b. 2- year-old c. 5-year-old d. 15-year-old Answer: A 14. Which bones are more likely to be broken in abusive situations? a. wrist bones b. long bones of arms and legs c. finger bones d. toe bones Answer: B 15. What is the most likely result of a fall from 3 feet? a. no injury b. minor injury c. fractures d. life-threatening injury Answer: A 16. The chance of death from a short fall (less than 1.5m/4.7 feet) is slightly less than a. 1 in 100 b. 1 in 1,000 c. 1 in 10,000 d. 1 in 100,000 e. 1 in 1,000,000 Answer: E 17. According to the research by Barlow et al. (1983), of the 61 children who fell four or more stories, how many were killed? a. 61 b. 60 c. 31 d. 14 Answer: D 17. How hot does tap water have to be before it causes second degree burns?

a. over 100 degrees b. over 115 degrees c. over 130 degrees d. over 145 degrees Answer: C 18. How hot does tap water have to be before it first causes a pain response? a. 100-105 degrees b. 114-118 degrees c. 125-130 degrees d. 145-165 degrees Answer: B 19. At what age are children most likely to be killed by maltreatment? a. 0 to 4 years b. 5 to 9 years c. 10 to 14 years d. 15 to 18 years Answer: A 20. Who is most likely to be guilty of fatal neglect? a. Mother b. Father c. Father substitute (step-father/boyfriend) d. All of the above are equally likely to be guilty of fatal neglect Answer: A 21. A mother tells you that her son was feeling ill and she massaged a heated oil on the child’s neck, spine, and ribs. Then she ran a coin along the skin leaving red marks. She has engaged in: a. Mongolian spots b. Cao Gio c. Caida de Mollera d. None of the above Answer: B 22. Brad is a victim of physical abuse. When a classmate accidentally bumbs into him, Brad gets very angry and insists that the other child hurt him on purpose. Brad is demonstrating a. immaturity b. aggression c. a hostile attribution d. none of the above Answer: C

23. Physically abuse children have higher rates of non-abused peers. a. juvenile delinquency b. adult criminal records c. violent crime d. all of the above Answer: D

than their

True/False 1.

A single bruise that is nonaccidental is evidence of abuse in all states.

Answer: False 2.

Corporal punishment is illegal in the United States.

Answer: False 3.

Corporal punishment is associated with a host of negative outcomes Answer: True 4.

The negative outcomes associated with corporal punishment do not persist into adulthood.

Answer: False 5.

Some countries have passed laws making corporal punishment illegal.

Answer: True 6.

Bans on spanking significantly reduce child physical abuse.

Answer: False 7.

Bans on spanking result in the elimination of spanking as a form of punishment.

Answer: False 8.

Children are more likely to attempt to hide abusive injuries than accidental injuries.

Answer: True 9.

Mongolian spots area a sign of abuse.

Answer: False 10.

Physically abused children are less likely to misbehave at school than are non-abused children.

Answer: False

11.

Physically abused children are more likely to have an insecure attachment than are non-abused children.

Answer: True 12.

Children who are physically abused are more likely to be aggressive than are non-abused children.

Answer: True

Short Answer Questions 1. Define child physical abuse.

Answer: An act by a caregiver that results in a nonaccidental injury to a child.

2. How does (insert home state) define child physical abuse?

Answer: will vary depending on state of residence 3. What is the difference between incidence and prevalence?

Answer: Incidence is the number of new cases occurring or being diagnosed in a year.

While prevalence is the number of cases that exist in a specified population at a given point in time.

4. Should corporal punishment be legal in the U.S.? Why or why not?

Answer: Either response is correct as long as the student supports their answer.

5. What positive effect is consistently linked with corporal punishment?

Answer: Immediate compliance 6. List 3 negative consequences associated with corporal punishment that are seen during childhood Answer: Any three of these: lower levels of moral internalization, increased aggression, increase in delinquent behavior, increase in antisocial behavior, poorer quality of relationship between parent and child, lower levels of mental health 7. What are the most common visible symptoms of a head injury?

Answer: depressed level of consciousness, respiratory distress, seizures, and vomiting 8. What are the visible symptoms of shaken baby syndrome?

Answer: extreme irritability, problems with feeding, lethargy, and poor muscle tone 9. Describe a glove burn.

Answer: A glove burn covers the fingers and hand with an even edge and no splash marks. It is a suspicious burn.

10. If a child had cigarette burns, what locations on the body would make you more suspicious of abuse? What areas would be less suspicious?

Answer: More suspicious areas: abdomen, genitals, areas of the body usually covered by clothing Less suspicious areas: fingers and mouth 11. Complete the following sentence. I would be concerned about maltreatment if a child had bruises that were….

Answer: There are several possible answers. For example: - located on the trunk of the body or behind the ears - at different phases of healing as indicated by color - shaped like an object 12. Complete the following sentence. I would be concerned about maltreatment if a child had tap water burns that were…

Answer: There are several possible answers. For example: - the burn made a perfect glove or sock impression with no splash marks - the body is burned with the exception of the buttocks 13. Define Cao Gio. Should it be considered child abuse? Why or why not?

Answer: Cao Gio is the Southeast Asian practice of coin rubbing. Coins, or spoons, dipped in heated oil, are rubbed along the child’s skin as a medical treatment. Students may argue that this is or is not abuse, as long as they support their claim.

14. List two examples of gendered physical abuse.

Answer: Female Genital Mutilation and Breast Ironing 15. What explanations are provided to explain why child physical abuse is associated with poor school performance?

Answer: Failure to perform well in school may be related to behavior problems that interfere with learning. Some children may suffer from intellectual problems due to brain injury that resulted from abuse; others do not perform well in school because they are too distracted by their home situation to concentrate. Still others struggle because they miss a lot of school. Students may be kept home when their parents are attempting to hide an abusive injury, or the child may be too hurt to attend. In either case, their sporadic attendance is, at least partially, to blame for their school failure. Finally, abusive families frequently move around a great deal, which leads to discontinuity in the educational process. All of these factors can negatively impact school performance.

16. Define suicidal ideation. How is it related to child physical abuse?

Answer: Suicidal ideation is thoughts about suicide; plans to end one's life; it may include suicide attempts. A history of child physical abuse increases the rate of suicidal ideation.

17. Define PTSD. Answer: Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder that occurs in response to experiencing extreme stress (generally involving actual or threatened death or serious injury). The person experiences symptoms including re-experiencing the event, avoiding stimuli reminiscent of the event, and increased arousal for at least one month.

18. List three psychiatric disorders associated with child physical abuse.

Answer: Any 3 of these: depression, PTSD, dysthymia, attention deficit hyperactivity disorder, conduct disorder, oppositional defiant disorder, anxiety disorder, Bipolar Disorder Additional Case Studies 1. This site has four case studies. The third one deals with physical abuse. The case study includes a synopsis, initial response, theories, interviews and action. http://www.childwelfare.gov/pubs/usermanuals/first_responders/appendm.cfm 2. This article, available on-line, provides five case studies dealing with physical abuse. http://www.mejfm.com/journal/March2006/childabuse.htm 3. This case, available on-line, describes a 6th grade boy whose father is using very harsh physical punishment. http://www.broward.k12.fl.us/studentsupport/Abuse/html/cases/the_hart.html 4. This chapter includes a two page vignette on physical abuse (pages 12 & 13) followed by a list of programs that might have made a difference (pages 13 & 14).

It is written by Widom and Wilson (2014).

Widom, C.S., & Wilson, H.W. (2015) Intergenerational transmission of violence.

In J. Lindert & I. Levav (Eds.), Violence and mental health. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-8999-8_2 Video Suggestions 1. There are video clips available on-line about the Jessica Beagley case (giving hot sauce to her 5-year-old son as a punishment). https://www.youtube.com/watch?v=l6TUN1ogMos This clip is 3 minutes and 2 seconds. It is ABC news coverage of the case. It was uploaded on 1-31-2011. https://www.youtube.com/watch?v=izynepkJ7hc This clip is 2 minutes and 47 seconds. It is ABC news coverage of the guilty verdict in her case. It was uploaded August 24, 2011.

2. This 2minute 41 second CNN clip shows Anderson Cooper interviewing Hallie, a young woman. Hallie posted video of her father, Judge William Adams, beating her with a belt. The video aired on Nov. 4, 2011. http://www.cnn.com/2011/11/03/justice/texas-video-beating/index.html This video can spark discussion when corporal punishment should be considered child physical abuse.

3. Radio Flyer (1992), directed by Richard Donner, tells the story of two boys who are abused by their alcoholic step-father. The story is available on Amazon.com

for $8.41. Encourage students to discuss the risk factors faced by the boys and to explore why they did not tell their mother or the police about the abuse.

4. This 2:05 video clip, Twin Baby Girls Victims of Child Abuse, Neglect, was originally aired on Feb. 13, 2012 by News 10 WAVY.com. The case tells of the discovery of seriously abused 4-month-old twins. http://www.youtube.com/watch?v=VgCP72ZLL6g 5. This short film (4:59 minutes) was produced by Childline. It Follows me Around: A Film About Physical Abuse was first posted on July 12, 2012. It tells of physical abuse from the point of view of a male victim who is a teenager. http://www.youtube.com/watch?v=pLaHfZgSOYY 6. This youtube video clip featured Dr. Adam J. Zolotor summarizing his research on the link between spanking and physical abuse. It is 3:11 minutes and was uploaded on Aug. 19, 2008. The clip is titled UNC Study Links Spanking and Physical Abuse. http://www.youtube.com/watch?v=rPFz2n1Qt7I 7. This 15 minute and 51 second Ted Med talk, pediatrician Nadine Burke Harris explores the connection between childhood trauma and subsequent health problems. This trauma includes abuse, but as well as other traumas. https://www.ted.com/talks/nadine_burke_harris_how_childhood_trauma_affects_ health_across_a_lifetime?language=en 8. This file is audio only for one minute, 48 seconds. It was produced by USA Today https://www.usatoday.com/story/news/nation/2020/05/13/hospitals-seeingmore-severe-child-abuse-injuries-during-coronavirus/3116395001/ You have to scroll down to the black box that says “Hospitals treating more severe child abuse injuries.” It talks about an increase in serious injuries during the pandemic of 2020 following the stay-at-home orders in Pennsylvania. It was posted May 13, 2020.

Discussion Topics 1. Assume you were asked to write the law about child physical abuse for your state.

What wording would you use? What things would you include/exclude?

2. How do you think we can best measure how common child physical abuse is in the United States?

3. Should corporal punishment be legal or illegal? If a law is passed to prevent corporal punishment, what should be done to educate parents about alternative methods of discipline?

4. Given that it is much more difficult to see bruising on a darkly pigmented child than on a lightly pigmented child, how can we protect children with darker skin?

5. Consider the stated motivations behind gendered practices like female genital mutilation and breast ironing. Given these motivations, what types of programs might be successful in reducing these practices?

Chapter 5 - Neglect Test Items 1.

If parents fail to provide for their children because they are unable to afford food and shelter a. they are guilty of neglect b. they are not guilty of neglect c. it depends on which state they live in Answer: C Which type of neglect is defined as the failure to meet the child’s needs for food, shelter, clothing, and protection from harm? a. Physical neglect b. Emotional neglect c. Medical neglect d. Mental Health Neglect e. Educational Neglect Answer: A 2.

3.

What subtype of neglect includes the failure to provide adequate affection. a. Physical neglect b. Emotional neglect c. Medical neglect d. Mental Health Neglect e. Educational Neglect Answer: B 4.

Beth did not want a child and was upset when she became pregnant. After the baby was born, she attended to his physical needs, but did not talk to him or cuddle him. What type of neglect is her son experiencing? a. Physical neglect b. Emotional neglect c. Medical neglect d. Mental Health Neglect e. Educational Neglect Answer: B 5.

What subtype of neglect is defined as the failure to provide prescribed medical treatment? a. Physical neglect b. Emotional neglect c. Medical neglect d. Mental Health Neglect e. Educational Neglect

Answer: C 6.

What subtype of neglect is defined as the failure to comply with recommended psychological treatment? a. Physical neglect b. Emotional neglect c. Medical neglect d. Mental Health Neglect e. Educational Neglect Answer: D 7.

Bobby has been diagnosed with anxiety by the school psychologist. The school psychologist recommends counseling and gives Bobby’s parents a referral to a local, low-cost psychologist with experience in working with young children who suffer from anxiety. Bobby’s parents think he will simply grow out of his anxiety, so they do not contact the psychologist. What subtype of neglect is this?

A. Physical neglect B. Emotional neglect C. Medical neglect D. Mental Health Neglect E. Educational Neglect Answer: D 8.

Which subtype of neglect includes the failure to enroll a child in school?

A. Physical neglect B. Emotional neglect C. Medical neglect D. Mental Health Neglect E. Educational Neglect Answer: E Jane’s mother does not enroll her in school because she has decided to provide home-schooling for Jane. However, due to the presence of her infant twins, she never gets around to starting Jane’s curriculum. What subtype of neglect is this?

A. Physical neglect B. Emotional neglect C. Medical neglect D. Mental Health Neglect E. Educational Neglect Answer: E 9.

10.

The most common type of reported maltreatment is: a. sexual abuse b. neglect c. physical abuse Answer: B

11.

Which of the following is the most common type of neglectful behavior?

A. Supervisory neglect B. Environmental neglect C. Both are equally common Answer: A 12.

What is the strange situation designed to measure?

A. child neglect B. child abuse C. intelligence D. attachment Answer: D Examining a parent’s emotional expression for cues about a situation is A. Social referencing B. A symptom of insecure attachment C. A symptom of neglect Answer: A 13.

15.

In the strange situation task, William clings to his mother prior to separation.

After separation, William appears to be angry with his mother when she returns and he resists her attempts to comfort him. This pattern of behavior illustrates a(an) attachment. a. secure b. avoidant c. resistant Answer: C 16.

In the strange situation task, Rachel is generally unresponsive to her mother. She is not upset when her mother leaves and she does not rush to greet her when she returns. This pattern of behavior illustrates a(an) attachment. a. secure b. avoidant c. resistant Answer: B 17.

Sandra keeps to herself. When her peers fill out a peer rating form she is not listed as a person they would most like to play with nor is she listed as a person they would least like to play with. Sandra is: a. peer rejected b. peer neglected c. peer accepted d. peer reinforced Answer: B

18.

When the children in a class fill out peer rating forms, many of them list Joseph as a person they wish to avoid. Nobody lists Joseph as a child they would like to play with. Joseph is a. peer rejected b. peer neglected c. peer accepted d. peer reinforced Answer: B 19. Adults with a history of neglect are more likely than their non-maltreated peers to a. drink heavily b. engage in risky sexual behavior c. have a psychological problem d. all of the above Answer: D 20. Which of the following is true regarding the intergenerational transmission of neglect? a. neglected mothers are NOT more likely to neglect their own child b. maternal neglect is a significant risk factor for neglect of her children c. all mothers who were neglected as children go on to neglect their own children d. the majority of mothers who were neglected go on to neglect their own children Answer: B 21. Which of the following is NOT associated with breaking the cycle of abuse? a. the presence of a supportive adult during childhood b. having a supportive, competent partner c. therapy to address the maltreatment d. dissociating the abuse experience Answer: D True/False 1.

Child neglect is an act of omission.

Answer: True 2.

Fetuses are covered by the neglect laws in all 50 states.

Answer: False 3.

Childhood obesity is never considered a form of medical neglect.

Answer: False 4.

State laws clearly and precisely describe what constitutes a suitable place of abode.

Answer: False

5.

Parents can be charged with neglect if their home is filthy.

Answer: True 6.

In some states, witnessing Criminal Domestic Violence is considered a form of child maltreatment.

Answer: True 7.

Parents cannot be charged with medical neglect if they refuse treatment for their child based on religious grounds.

Answer: False 8.

Failure to vaccinate your child is always grounds for medical neglect.

Answer: False 8.

Neglect is the most common form of child maltreatment.

Answer: True 9.

Neglect is the leading cause of fatalities from child maltreatment.

Answer: True 10.

In cases of neglect, the perpetrator is almost always the father.

Answer: False 11.

Neglect alone may lead to symptoms of Post-Traumatic Stress Disorder.

Answer: True 12.

The consequences of neglect do not appear to persist into adulthood.

Answer: False

Short Answer Questions 1. What does it mean to say that neglect is chronic in nature?

Answer: With neglect, we are defining a pattern of parental behavior rather than just a few instances.

2. Define medical neglect.

Answer: Failure to provide prescribed medical treatment or failure to secure medical treatment in a timely fashion (when a reasonable person would have known treatment was needed).

3. List 3 arguments for the prosecution of childhood obesity as medical neglect.

Answer: Any 3 of these: - Obesity is associated with health concerns - Obesity can be fatal (although very rare) - Obesity is associated with social problems - Obesity is associated with future harm; including a shortened life-span 4. List 3 arguments against the prosecution of childhood obesity as medical neglect.

Answer: Any 3 of these: - Obesity may be due to genetics or endocrine problems - Harm of obesity is rarely imminent - No evidence that obese children will do better in protective care - Removing the child from the home may pose a risk that outweighs any health benefit - Parents do not have total control over what their children eat 5. Define child endangerment.

Answer: Child endangerment is unnecessarily exposing a child to possible harm.

6. Define nonorganic failure to thrive.

Answer: Infants, who were once in the normal range, now fall below the fifth percentile for height and weight in the absence of any organic explanation may be diagnosed with nonorganic failure to thrive.

7. List 4 possible signs of neglect in infancy.

Answer: Any 4 of these: - Nonorganic failure to thrive - Insecure attachment - Poor muscle tone - Flat, bald spot on the back of the head - Lack of smiling, babbling - Rashes/infections - Lower intelligence 8. List four explanations for the academic deficits seen in neglected children.

Answer: First, neglected children may be less persistent and less enthusiastic than their peers. Second, students may have delays in cognitive abilities related to

language, Third, students may struggle due to poor attendance at school. Fourth, neglected children have lower IQs than their peers.

9. What is the most likely explanation for why neglected children are peer neglected?

Answer: The most likely explanation is that neglected children tend to be aggressive and aggression is linked to peer rejection.

10. List 3 possible effects of neglect seen in adolescents.

Answer: Any 3 of these: - socially isolated - intellectual/academic problems - higher rates of delinquency - increased problems with substance use and abuse - increased rates of risky behavior - higher rates of psychiatric disorders 11. List 3 possible effects of neglect seen in adulthood.

Answer: Any 3 of these: - An increase in sexually transmitted diseases - More likely to engage in risky sexual behavior - More psychological problems - Problems with alcohol

Additional Case Studies 1. Varness (2010) presents the case of a nine-year-old girl, Tiffany who is morbidly obese. When Tiffany’s mother is confronted by the pediatrician, she makes it clear that she does not intend to make changes. The doctor must then decide if this is a case of medical neglect. Varness goes over the criteria for medical neglect and then relates each criteria to Tiffany’s case. The article concludes with a suggested course of action.

Varness, T. (2010). Deos pediatric obesity indicate child neglect? Virtual Mentor, 12 (4), 263-267.

2. Cox (2009) reviews the case of a mother how is charged with neglect because her 14-year-old son weighed 555 pounds. This case received a great deal of media attention and many article, pictures, and video clips can be found on-line. The mother’s name is Jerri Gray and the case took place in South Carolina.

Cox, L. (2009, June 29). Courts charge mother of 555-pound boy. ABC News Medical Unit. Retrieved from: http://abcnews.go.com/Health/WellnessNews/story?id=7941609 https://www.youtube.com/watch?reload=9&v=FLxHmfXEf00 - 5 minute 10 second video from CBS overviewing case https://www.nydailynews.com/life-style/health/child-obesity-abuse-court-decides-mom-jerri-gray-neglected-555-pound-14-year-old-son-article-1.428096

-

Picture and article

https://www.wyff4.com/article/video-update-on-upstate-boy-who-weighed-555pounds/6503510 - 4 minute 21 second clip from NBC news posted Dec.. 6, 2013 – Gives an update on the case when son is 18 years old.

3. Merrick et al. (2012) present 5 case examples. In each case a newborn screening reveals that the child has a disorder. The family is notified via phone, mail, or in person. The family is described as having no insurance, Medicaid, or private insurance. In all cases the family does not seek follow up services. The question is whether the doctor would report medical neglect. The article includes the results obtained when the vignettes were sent to 102 professionals in the field of pediatric medicine.

Merrick, M. T., Butt, S. M., Jent, J. F., Cano, N. M., Lambert, W. F., Chapman, A. V., Griffith, J. F., Ciener, D., Dandes, S. K., & Sanders, L. M. (2012).

No follow-up after positive newborn screening: Medical neglect? Child Maltreatment, 15 (4), 315-323. https://doi.org/10.1177/1077559510384983 4. Green (1991) present a 13 page case description of a neglected child, Alan, aged 13-years. The commentary includes looking at medical and legal issues as well as family and social issues. It also covers the assessment of both the child and his mother. The description ends with treatment options.

Green, A. H. (1991). Child neglect. In R. T. Ammerman & M. Herson (Eds.).

Case studies in family violence (pp. 139-152). Plenum Press.

Video Suggestions 1. A 45 minute video lecture with power point is available on-line at http://videos.med.wisc.edu/videos/7485. In the video Dr. Todd Varnes presents a lecture entitled Does Severe Childhood Obesity Constitute Medical Neglect? Dr. Varnes presents case studies from the U.K. and the U.S. He reviews the consequences of obesity and the criteria for medical neglect before discussing when childhood obesity might warrant removal from the home.

2. Video clip from CNN on obesity and medical neglect. See Case Example #2 above.

3. Broken Child: Case Studies of Child Abuse (2004). This 61 minute dvd is produced by HBO. Several real cases of child maltreatment are documented including a child who has Fetal Alcohol Syndrome and a mother who uses crack and works as a prostitute while pregnant. Warning: The language is very graphic.

4. http://www.youtube.com/watch?v=cMQirLFI2Q4 This 3:45 minute video clip covers the arrest of three adults for child neglect in Oklahoma City. A 5-year-old was being kept in a closet, beaten, and underfed. She weighed just 19 pounds.

Interesting point: 5 other children in the home were not being maltreated. The child who was being maltreated had a different father than the other children.

5. http://www.youtube.com/watch?v=QZ1zXJVv9SQ This 2:48 minute video clip covers the arrest of four adults after two children aged 2-years and 3-years were found walking in the road. Another child, an infant was crying in an infant seat in the home. All four adults were passed out and the home was filthy.

6. This 2:23 minute video, Mom Charged with Child Neglect, from News Channel 9 describes the case of a 4-year-old girl who was found outside alone in only a shirt and underwear. Apparently, she left her home while her mother was sleeping.

This was not the first time the child had been found unsupervised. The original air date was August 6, 2012. http://www.youtube.com/watch?v=NlwClWNr2pE 7. This 2:39 minute video clip, Muncie Stepmom Found Guilty of Child Neglect in Death of 5-Year-Old, was produced by Fox News. It describes the jury verdict and reviews the case of severe neglect. Original air date – July 27, 2011. http://www.youtube.com/watch?v=mFzFCN9siug 8. This 2:06 minute video clip, NN Mother Arrested for Child Neglect, was produced

by NBC News and first aired on July 20, 2012. It describes a case of felony child neglect involving teenage girls – 13 and 14-years-old. http://www.youtube.com/watch?v=vtR6svteJvw 9. This 2:01 minute video clip from NBC News presents a case of child neglect in Port St. Lucie based on extreme filth in the home. https://www.youtube.com/watch?v=_Baj5ka7t-s 10. This 2:25 minute video clip from NBC News presents the case of parents charged with child neglect after they were found to be living in a Walmart parking lot with their children. https://www.youtube.com/watch?v=EPWtRSX5VNY

Discussion Topics 1. Should child obesity be grounds for charging for parents with medical neglect?

Have students debate this issue.

2. Have the students discuss the phrase “home or suitable abode.” Is it sufficient to live in a tent? A car? A camper? Does it depend on the environment (temperate versus very cold or hot)? Are electricity and indoor plumbing required? What if parent are providing as much as they can based on a limited income?

3. Many experts think that the consequences of neglect may be more severe than the consequences of physical or sexual abuse. Have your students discuss why neglect might have such a dramatic impact on development.

4. Have the students look up their state law on neglect and the laws in three other states for comparison. Ask them to note what, if anything, they like better about their state law and what, if anything, they are less pleased with. How would they write the child neglect law if it was up to them?

5. Seth Pollak has examined children who were raised in orphanages in Russia and Romania before being adopted by parents in the US. He assesses the deficits associated with extreme neglect during infancy. This can provide an interesting discussion of how to adequately prepare adoptive parents to meet the needs of their adopted children.

6. Kwak and colleagues found that neglect was associated with an increase in Smartphone addiction. Because so many students are very interested in cell phone use, they may enjoy discussing this article: Kwak, J. Y., Kim, J. Y., & Yoon, Y. W. (2018). Effect of parental neglect on smartphone addiction in adolescents in South Korea. Child Abuse & Neglect, 77, 75–84. https://doi.org/10.1016/j.chiabu.2017.12.008

Chapter 6 – Psychological Maltreatment Test Items 1. A mother tells her son he is no good, lazy bum and she wishes he were never born.

This mother is guilty of a. Psychological neglect b. Psychological abuse c. Physical neglect d. Physical abuse Answer: B 2. A mother did not want to have a third child. When the baby is born, she feeds her and changes her as needed, but she does not give her any additional attention. This mother is guilty of a. Psychological neglect b. Psychological abuse c. Physical neglect d. Physical abuse Answer: A 3. With regard to state statutes, which of the following statements is true? a. Psychological maltreatment is not mentioned by most states. b. Psychological maltreatment is addressed by all 50 states c. Psychological abuse is more clearly addressed than is psychological neglect. d. Psychological neglect is more clearly addressed than is psychological abuse.

Answer: C 4. Which edition of the DSM first included psychological maltreatment? a. DSM-II b. DSM-III c. DSM-IV d. DSM-V Answer: D 5. A father continually belittles his son; calling him names and shaming him. Which subtype of psychological maltreatment is this? a. Spurning b. Terrorizing c. Isolating d. Exploiting/Corrupting e. Denying Emotional Responsiveness Answer: A

6. Recently a father posted video of his 18 month old son smoking a joint on youtube.

This could certainly be considered physically abusive. In addition, what subtype of psychological maltreatment would be an appropriate label? a. Spurning b. Terrorizing c. Isolating d. Exploiting/Corrupting e. Denying Emotional Responsiveness Answer: D 7. A father tells his son that if he does not earn straight As on his report card, he will kill his dog. This represents which subtype of psychological maltreatment? a. Spurning b. Terrorizing c. Isolating d. Exploiting/Corrupting e. Denying Emotional Responsiveness Answer: B 8. Because Bob fell in with a bad crowd when he was young, he does not let his son, Eric, interact with other children. He homeschools Eric and does not let him out of the house unsupervised even though Eric is 15 years old. This represents which subtype of psychological maltreatment? a. Spurning b. Terrorizing c. Isolating d. Exploiting/Corrupting e. Denying Emotional Responsiveness Answer: C 9. According to Hamarman and Bernet, if there is no intent to harm and the child is not harmed by a psychologically abusive behavior than a. there is no maltreatment b. the maltreatment is mild c. the maltreatment is moderate d. the maltreatment is severe Answer: B 10. According to research, among families who were guilty of physical abuse, what percentage were also guilty of psychological maltreatment? a. 100% b. Approximately 90% c. Approximately 80% d. Approximately 45% Answer: B

11. According to research, among families who were guilty of psychological maltreatment, what percentage were also guilty of physical abuse? a. 100% b. 68-80% c. 18-45% d. 6-11% Answer: C 12. According to Hamarman and Bernet, moderate psychological maltreatment means that a. there was both intent to harm and harm b. there was either intent to harm or harm, but not both c. there was neither intent to harm nor harm Answer: B 13. According to the NIS-IV Harm Standard, how many children were harmed by psychological abuse in 2005-2006? a. 1 per 1,000 b. 2 per 1,000 c. 3 per 1,000 d. 4 per 1,000 Answer: B 14. According to the NIS-IV Harm Standard, how many children were harmed by psychological neglect in 2005-2006? a. 1 per 1,000 b. 1.6 per 1,000 c. 2 per 1,000 d. 2.6 per 1,000 Answer: D 15. According to the NIS-IV Endangerment Standard, how many children were endangered by psychological abuse in 2005-2006? a. 1.0 per 1,000 b. 2.3 per 1,000 c. 4.1 per 1,000 d. 5.6 per 1,000 Answer: C 16. According to the NIS-IV Endangerment Standard, how many children were endangered by psychological neglect in 2005-2006? a. 5.0 per 1,000 b. 7.5 per 1,000 c. 10.2 per 1,000 d. 15.9 per 1,000 Answer: D

17. Which of the following is true about the NCANDS data on the incidence of psychological maltreatment? a. Most states report no cases of psychological maltreatment b. There is remarkable consistency across states in terms of the incidence of psychological maltreatment c. The rates of reported psychological maltreatment vary widely among the states Answer: C 18. When comparing the rates of psychological maltreatment according to retrospective data and according to the NIS-IV a. the rates are nearly identical b. the NIS rates are significantly higher c. the rates from retrospective studies are much higher Answer: C 19. Which theory would state that a child’s basic needs and psychological needs must be met before they can reach their full potential? a. Maslow – Human Needs Theory b. Erikson – Psychosocial Theory c. Attachment Theory Answer: A 20. Whose theory says that as children age they face a series of psychosocial crises that shape their development? a. Maslow’s b. Erikson’s c. Bowlby’s d. Freud’s Answer: B 21. According the study by Haferkemp et al. (2015), the trauma symptom of dissociation is seen a. Only in victims of physical abuse b. Seen more commonly in victims of emotional abuse than in other maltreatment victims c. Seen equally frequently across all types of maltreatment d. Almost never seen in cases were death was not a realistic fear Answer: B

22. Victims of psychological maltreatment are at an increased risk for anxiety and depression a. Only during childhood b. During childhood and persisting into adulthood c. Only in adulthood d. None of the above Answer: B 23. According to the study by Cohen et al. (2019), which type of maltreatment was associated with an increase in anhedonia? a. Emotional abuse b. Emotional neglect c. Both emotional abuse and neglect d. Neither emotional abuse nor emotional neglect Answer: B 24. According to Rorty et al. (1994) the most common type of maltreatment history among women suffering from Bulimia was a. Sexual b. Physical c. Psychological d. Munchausen Syndrome by Proxy Answer: C 25. According to the research reviewed by Maguire et al. (2015), learning problems in victims of children who have been emotionally abused may be related to elevated symptoms of a. Schizophrenia b. Depression c. Conduct Disorder d. Attention Deficit Hyperactivity Disorder Answer: D

True/False 1.

The United States has a uniform definition of psychological maltreatment that holds across all states and U.S. territories.

Answer: False 2.

Reading the state statutes on child maltreatment make it clear what constitutes psychological maltreatment.

Answer: False

3.

Psychological maltreatment can have a negative impact on a child’s physical health.

Answer: True 4.

A history of psychological maltreatment increases the likelihood that a child will engage in non-suicidal self-injurious behaviors.

Answer: True 5.

Unlike other forms of maltreatment, psychological abuse is not associated with an increased risk for substance use during adolescence/young adulthood.

Answer: False

Matching Which subtype of psychological maltreatment is most evident in the following scenarios?

A. Spurning B. Terrorizing C. Isolating D. Exploiting/Corrupting E. Denying Emotional Responsiveness F. Mental Health, Medical, and Educational Neglect 1.

Ms. Jenkins is extremely worried about Bobby getting hurt. Even though he is almost 8 years old, she does not like him to be out of her sight. She does not allow him to play unsupervised in the yard or even in his room.

2.

One neighbor overheard another telling her son, “I wish you were never born.

You can’t do anything right. You are so stupid!”

3.

Mr. James realizes that it is easier for children to pick pockets than it is for adults – they are smaller and less likely to arouse suspicion. So, Mr. James teaches his young son to pick pockets at a busy mall.

4.

Even though Ms. Smith knows her friend deals drugs and hangs out with a violent gang, she lets her daughter with this friend so she can go to a party.

Answer: 1 – C; 2 – A, 3 – D, 4 - B

Short Answer Questions 1. Compare and contrast the terms psychological and emotional.

Answer: Emotional means feelings and emotional development entails learning to interpret and express emotions. Psychological means pertaining to the mind. It includes emotional responses, but also refers to other cognitive processes.

2. Provide two reasons that Hamarman and Bernet (2000) give to argue that psychological maltreatment should be defined in terms of parental behavior rather than child outcome?

Answer: 1. It would allow for intervention before harm occurred 2. It is difficult to determine that any child outcome is due to one specific antecedent 3. According to McGee and Wolfe, fill out the chart below with the following terms: physical abuse; psychological abuse, type of abuse depends on act (you may use the terms more than once) Parental Act Physical Non-Physical Physical Child Outcome Psychological

Answer:

Parental Act

Physical Child Outcome Psychological

Physical

Non-Physical

Physical Abuse

Psychological Abuse

Type of Abuse depends on act

Psychological Abuse

4. Do you prefer the APSAC’s or Glaser’s definition of psychological maltreatment?

Answer: There is no one correct answer. As long as the student’s answer reflects an accurate understanding of the theories, it would be correct.

5. Explain the negative consequences of psychological maltreatment in terms of Maslow’s theory.

Answer: Maslow argued that until our lower level needs are met, we cannot reach what we all strive to achieve – self-actualization. Psychological maltreatment interferes with needs of belonging, love and esteem. Therefore, it blocks development at a low level.

6. What did Okado and Azar (2011) discover about the relationship between inappropriate emotional relationships with mothers and subsequent risk for child maltreatment?

Answer: They found that participants who had experienced inappropriate emotional relationships with their own mothers (either enmeshed or

disengaged) had higher scores on the Child Abuse Potential Inventory and less realistic views of children. Both of these things increase the risk that a person will maltreat their own child.

7. List 5 possible problems in social functioning seen in victims of psychological maltreatment.

Answer: Any 5 of these: Attachment problems Poor social competence Noncompliance Aggression Violence Delinquency Social Isolation Poor empathy skills Sexual maladjustment 8. List one factor related to greater resiliency and one related to greater harm in the face of psychological maltreatment.

Answer: Having a trusted, supportive adult in their life helps children to be resilient in the face of psychological maltreatment. Living in a family where domestic violence is a problem is associated with greater harm.

Additional Case Studies 1. Marshall (2012) provides 3 fictional case studies dealing with psychological maltreatment. After each case, Marshall uses the APSAC categories to identify the types of maltreatment evident in the scenarios. She also uses Hamarman and Bernet’s (2000) criteria for indicating whether the case represents mild, moderate, or severe psychological maltreatment.

Marshall, N. A. (2012). A clinician’s guide to recognizing and reporting parental psychological maltreatment of children. Professional Psychology: Research and Practice, 43(2), 73–79. https://doi.org/10.1037/a0026677 2. Binggeli et al. (2001) present a case study on psychological maltreatment. This 6 page description is based on court documents and it describes a severe case of emotional abuse along with physical abuse. Fourteen study questions follow the case study.

Binggeli, N. J., Hart, S. N., & Brassard, M. R. (2001). Psychological maltreatment: Case Study. In J. R. Conte (Ed.) Psychological Maltreatment of Children: The APSAC Study Guides 4. Thousand Oaks, CA: Sage Publications.

3. Brassard et al. (1991) provide a 12 page case description about a family that participated in their research project on psychological maltreatment. The family members are all described along with the case facts and the assessment procedures. The authors note examples of spurning, terrorizing, isolating, exploiting/corrupting and denial of emotional response. Medical, legal, social and family issues are also addressed. The description ends with treatment options.

Brassard, M. R., Hart, S. N., & Hardy, D. B. (2001). Psychological and emotional abuse of children. In R. T. Ammerman & M. Hersen (Eds.). Case Studies in Family Violence. New York, NY: Plenum Press.

Video Suggestion 1. Precious (2009). This 109 minute movie is a Lionsgate film.

The movie tells the story of Precious Jones – the victim of emotional, sexual, and physical abuse. Warning – the film is rated R and contains very harsh language and deals with incest. The movie was nominated for 6 Academy Awards, including Best Picture.

The movie can be purchased for $9.99 on Amazon Prime or rented for $1.99.

Note: This film depicts several types of maltreatment. I recommend it here because I think its portrayal of emotional abuse is the most salient.

2. In this 2:33 minute youtube clip (http://www.youtube.com/watch?v=DYHrKmcuLYE), Dr. Sylvia Geering discusses The Developmental Costs of Emotional Abuse for Children. She notes the effects of emotional abuse and talks about ways to prevent emotional abuse in your own family. The video was uploaded on April 13, 2011.

3. The video Recognizing Child Abuse: Neglect and Emotional Abuse is produced

by Health Portal. The video was produced in 2008. It covers both emotional abuse and emotional neglect. The obligations faced by mandated reporters are also addressed. It is available on YouTube: https://www.youtube.com/watch?v=cLfZXbShgzk The video was uploaded on Jan. 3, 2012.

4. Psychological Maltreatment: A Central Issue in Violence Against Children is an hour a half long webinar presented by ISPCAN and APSAC. It is available on YouTube: https://www.youtube.com/watch?v=1RpatfXNhYA This video was uploaded on April 20, 2018.

5. The American Academy of Pediatrics posted a 3 minute, 48 second video on the long-term effects of child maltreatment, including emotional abuse. The video

was posted in October 2020. https://pediatrics.aappublications.org/content/146/4/e20200438

Discussion Topics 1. Have students review the child abuse laws from several states. Tell them focus on the definitions (or lack thereof) for psychological abuse and neglect. https://www.childwelfare.gov/topics/systemwide/laws-policies/state/ Next, have the students discuss the similarities and differences they note across states. Which state’s law is the clearest in their opinion? Which state law is the best in their opinion? If they could draft a definition of their own state to use, how would they define psychological abuse and psychological neglect?

2. Is it ever okay to tell your child you are going to kill them? If so, under what conditions is this permissible? If not, why not?

3. Have students come up with instances of psychological maltreatment. Then, each student should ask their classmates to classify the act according to the APSAC criteria and then according to Glaser’s criteria. Which criterion is easier to use?

4. For several specific acts, have students try to agree on where to draw the line between good parenting, poor parenting and maltreatment.

Example 1: Joe, who is 12 years old, is consistently getting in trouble when he hangs out with a group of friends his parents suspect may be a gang. Joe has been caught vandalizing twice and shoplifting three times. His parents want to keep him from these peers. With respect to the issue of isolating, what type of response would reflect good parenting? Poor parenting? Maltreatment?

Example 2: Sally (14-years-old) is extremely lazy. She refuses to clean her room or even her own body. Sally has no physical or mental limitations that prevent her from doing her chores; she just refuses to help at all. With respect to the issue of spurning, what type of response would reflect good parenting? Poor parenting?

Maltreatment?

Example 3: Christy, age 3 years, is very needy. She wants her mother’s constant attention. When her mother’s friend comes to visit, the adults can barely talk because Christy constantly begs for attention. With respect to the issue of denying emotional responsive responsiveness, what type of response would reflect good parenting? Poor parenting? Maltreatment?

5. Why do you think the incidence of psychological maltreatment is so much higher in retrospective studies than in data reported by the NIS or NCANDS? Which estimates do you think are likely to be more accurate?

6. Given the research on the effects of psychological maltreatment, what symptoms should you look for in children you work with? Would this differ depending on the age of the child?

Chapter 7 – Sexual Abuse Test Items 1. In the 1970s, which was true about publications regarding child sexual abuse? a. there were no publications b. there were published experiments with good control groups c. some case studies were published d. there were correlational studies Answer: C 2. Within the United States each state identifies an age at which an individual can consent to sexual conduct. This age is between: a.

13 – 17 years old b.

14 – 18 years old c.

16 – 18 years old d.

16 – 20 years old Answer: C 3. Acts can be considered abusive even when the perpetrator is not over 18.

Experts generally state that an age difference of years is sufficient to indicate abuse. a. two years b. four years c. five years d. eight years Answer: C 4. Flashing would be considered: a. molestation b. contact abuse c. non-contact abuse d. penetration Answer: C 5. With regard to the incidence of child sexual abuse, the NIS found a. Significantly lower rates in 2005-6 than in 1993 b. Significantly higher rates in 2005-6 than in 1993 c. The same rates in 2005-6 and 1993 d. Rates of sexual abuse were not measured in 1993, so comparisons cannot be made.

Answer: A

6. The National Center for Victims of Crime estimates that approximately adult women and adult men recall a history of CSA. a. 1 in 20; 1 in 5 b. 1 in 5; 1 in 10 c. 1 in 10; 1 in 5 d. 1 in 5; 1 in 20 Answer: D 7. When comparing the rates of sexual abuse according to retrospective data and according to the NIS a. the rates are nearly identical b. the NIS rates are significantly higher c. the rates from retrospective studies are much higher Answer: C 8. Which term describes the proportion of people in a population who have ever experienced sexual abuse? a. incidence b. prevalence c. both incidence and prevalence d. neither incidence nor prevalence Answer: B 10. Williams (1994) interviewed 129 women with a documented history of child sexual abuse. She found a. All of the women disclosed the previous abuse b. 38% of women failed to disclose the abuse c. None of the women reported the past abuse d. The women refused to discuss the abuse even though they clearly recalled the abuse Answer: B 12. Which of the following explains the less common relationship between pedophiles and their victims? a. acquaintance, friend or family friend b. stranger Answer: B 13. Which relationship marks the most common perpetrator of sexual abuse? a. father b. extended family member c. stranger d. acquaintance Answer: D

14. Approximately what percentage of sexual abuse perpetrators are under the age of 18 years? a. 6% b. 14% c. 22% d. 29% Answer: D 14. The greatest number of sexual abuse perpetrators are between the ages of peak a. 18 and 29-years old b. 28 and 30-years old c. 35 and 45-years old d. 45 and 55-years old Answer: A 15. What did data from the ChildLine study reveal about the sex of victims and perpetrators? a. When the victim is female, most perpetrators are also female b. When the victim is a female, most perpetrators are male c. When victims are male, almost all perpetrators are female d. None of the above are true Answer: B 16. What percentage of identified cases of CSA are female victims? a. 10-20% b. 20-40% c. 50-70% d. 80-90% Answer: D 17. Which of the following is true with regard to reported sexual abuse victims? a. they are more likely to be male b. they are more likely to be female c. they are equally likely to be male or female d. they are all female Answer: B 19. According to the report by the researchers at John Jay College, approximately what percentage of priests and deacons were guilty of child sexual abuse between 1950 and 2002? a. 1% b. 4% c. 10% d. 22% Answer B

20. According to the report by the researchers at John Jay College, the rates of sexual abuse cases in the Catholic Church were highest in a. 1950s and 1960s b. 1970s and 1980s c. 1990s and 2000s d. abuse was equally high across all decades studied Answer B 21. According to research by Mercado, Tallon, and Terry (2008) most sexually abusive priests had a. one victim b. two to three victims c. 4 to 9 victims d. 10 or more victims Answer A 22. According to research by Schumacher and Carlson (1999) which of the following is a risk factor for sexual abuse within a daycare setting? a. a large staff b. centers run by multiple members of the same family c. both of the above are risk factors d. neither of these are risk factors Answer: B 23. When high school students were asked to identify which, if any, of the teachers was a “letch,” a. nearly all male faculty were listed b. the students said that none of their teachers behaved inappropriately c. the majority of students identified the same teacher d. students were equally likely to name female and male teachers Answer: C 24. A review of known images of child pornography by Cooper (2009) showed that what percentage of images were taken by close relatives or family friends? a. 10% b. 25% c. 50% d. 70% Answer: D

25. When Quayle et al. (2018) examined images of child pornography, they found that a. the majority of images were of males b. over 44% of images were self-taken c. images of the youngest children were almost all taken by strangers d. children under 11 were more likely to be in self-taken images than were older children Answer: B 25. The average age at entrance into sex trafficking is estimated to be a. 10-years-old b. 13-years-old c. 15-years-old d. 18-years-old Answer: B 26. Roland et al. (1989) found that victims of sexual abuse had the highest (worst) scores on the MMPI if they were a. abused by a stranger b. abused by a father or stepfather c. abused by a family friend d. the relationship with the perpetrator did not determine MMPI scores Answer: B 27. Which symptom is the most frequently reported among adult victims of CSA? a. PTSD b. anxiety c. depression d. bulimia Answer: C 28. People who suffer from excessive watchfulness or wariness and who constantly scan their environment for signs of danger are said to be a. depressed b. antisocial c. hypervigilant d. dissociating Answer: C 29. Which types of victims report the highest level of PTSD symptoms? a. noncontact victims b. molestation victims c. rape victims d. rate of PTSD symptoms does not vary with type of abuse Answer: C

30. Which personality disorder is most strongly associated with a history of child sexual abuse? a. Antisocial Personality Disorder b. Borderline Personality Disorder c. Histrionic Personality Disorder d. Narcissistic Personality Disorder Answer: B 31. is a way for the mind to defend against full awareness of abuse. a. Depression b. PTSD c. Dissociation d. Anxiety Answer: C 32. The ability of the mind to reject unacceptable thoughts, desires, or memories and force them into the unconscious is a. Psychosis b. Depression c. PTSD d. Repression Answer: D 33. A person’s belief that he or she is capable of doing what is necessary to produce the desired result in a given situation is a. attitude b. attribution c. self-efficacy d. self-esteem Answer: C 34. Which type of sexual behavior is not common among children? a. masturbation b. looking at each other’s genitals c. drawing genitals d. simulating intercourse Answer: D

35. Based on a meta-analysis, Rind, Tromovitch, and Bauserman (1998) concluded that a. the effects of childhood sexual abuse are not typically intense or pervasive. b. sexually abused children have significant difficulties functioning in a wide range of domains. c. about half of sexual abuse victims have no problems while the other half have serious problems. d. none of the above Answer: A 36. What was Clancy’s (2009) main finding about sexual abuse victims? a. most children are traumatized by the abuse at the time it is occurring b. most children are not traumatized by the abuse at the time it is occurring c. sexual abuse does not lead to any problems during adulthood d. none of the above Answer: B 37. According to Clancy (2009) what percentage of sexual abuse victims attempted to stop the abuse from happening? a. less than 5% b. 25% c. 75% d. 100% Answer: A 38. Which of the following statements is true? a. males and females have dramatically different responses to being sexually abused b. males show more externalizing symptoms following abuse than do girls c. males show more internalizing symptoms following abuse than do girls d. there are no differences between how boys and girls react to sexual abuse Answer: B True/False 1.

The sexual abuse of children appears to be a relatively new phenomenon; the product of modern times.

Answer: False 2.

All 50 states include sexual abuse in their definitions of child maltreatment.

Answer: True 3.

Female perpetrators are as likely to be reported to the authorities as are male perpetrators.

Answer: False

4.

In most cases of sexual abuse, the sexual behavior is introduced slowly.

Answer: True 5.

Perpetrators of sexual abuse are more likely to use threats than bribes or treats to induce compliance in their victims.

Answer: False 6.

Lack of parental supervision increases the risk of child sexual abuse.

Answer: True 7.

The majority of Catholic Priests who were guilty of child sexual abuse between 1950 and 2002 had more than 10 victims each.

FALSE 8.

Historically, children who engage in prostitution have been treated as criminals.

Answer: True 9.

Adults with a history of child sexual abuse are less compliant than are their non-abused peers.

Answer: False 10.

Researchers have established a set of symptoms that are unique to victims of sexual abuse.

Answer: False 11.

Victims of childhood sexual abuse are at an increased risk for suicidal ideation.

Answer: True 12.

Victims of child sexual abuse are up to five times more likely to be diagnosed with some type of anxiety disorder than are non-victims.

Answer: True 13.

It is clear that a history of child sexual abuse significantly increases the risk of developing anorexia in female victims.

Answer: False 14.

There is widespread agreement among professionals that people can repress and later accurately recover memories.

Answer: False 15.

There is strong evidence that it is possible to create false memories for negative childhood events, even among healthy adults.

Answer: True

16.

The FBI has been able to uncover a good deal of evidence supporting claims of satanic sexual abuse.

Answer: False 17.

Sexual curiosity and sex play are common among children.

Answer: True 18.

Sexual problems related to a history of childhood sexual abuse disappear by early adulthood.

Answer: False 19.

Researchers have found more similarities than differences between male and female responses to sexual abuse.

Answer: True 20.

Between one quarter and one third of sexual abuse victims do not seem to experience any negative effects from their abuse.

Answer: True Short Answer Questions 1. Define “child sexual abuse.”

Answer: Child sexual abuse is the involvement of a child in any sexual activity where consent is not or cannot be given.

2. What are the consequences of having a broad definition of CSA? Answer: A broad definition leads to very high incidence estimates. It also means that a large range of acts are covered by the same term. A broad definition also makes it more difficult to assess effects. Finally, broad definitions do not address the context of the act.

3. Define sexual exploitation.

Answer: use of a child (under the age of 18 years) for the purpose of prostitution or pornography.

4. Provide four reasons why a child might not disclose sexual abuse.

Answer: Any 4 of these: 1. The perpetrator may have threatened the child not to tell; 2. the child may want to protect the perpetrator; 3. The child may fear they will be blamed; 4. The child may lack the necessary language skills; 5. The child may not realize that what is happening is wrong; 6. The child may fear that others will not believe them.

5. What are the possible explanations for the decline in reports of sexual abuse between 1994 and 2001?

Answer: Sexual abuse may have been over-reported in the late 1980s. It might reflect a true decline in abuse. It might be that more stringent definitions were instituted.

6. In the context of child sexual abuse, what is meant by the term “grooming”?

Answer: Grooming is preparing the situation and the child for the abuse. The perpetrator needs to gain the trust of the guardians and the child. They then need to build an exclusive relationship with the child. Finally, the perpetrator slowly introduces sexuality into the relationship.

7. How might a priest or other religious person use their faith to excuse their sexual abuse of children?

Answer: A priest may believe that “As a priest, everything is alright” or that because God called them, knowing their inclinations, it must be alright. Others may argue that God would not allow the abuse if He thought it was bad or that God will protect the children they victimize. Finally, some may think that by doing other good works they will be forgiven for their molestation of children.

8. What was accomplished by the U.S. Trafficking Victim Protection Act? Answer: In passing this legislation, the federal government recognized trafficking as a form of slavery wherein the children who were forced to perform sexually for money were victims, not criminals. The act also provides substantial penalties for those who use children in this manner.

9. Define hypervigilance and explain how it is related to child sexual abuse.

Answer: Hypervigilance is excessive watchfulness or wariness; constant scanning of the environment for signs of danger. A history of sexual abuse is associated with hypervigilance that, in turn, leads to anxiety.

10. How do recovered memories differ from normal memories?

Answer: The recovered memories tend to be overly detailed, the include memories from very young ages, they are bizarre, and they are not supported by physical evidence.

11. According to Clancy (2009), why does childhood sexual abuse have negative consequences if children are not traumatized by it when it is occurring?

Answer: Dr. Clancy says that as the children grow and learn about sexuality, they realize that what happened to them was sexual abuse and that it was terribly wrong. These teenagers and young adults then suffer from the betrayal they only now understand. They feel manipulated and gullible. Furthermore, because child sexual abuse is "supposed to be traumatic" they think there is something wrong with them for the way they reacted. They don't understand why they did not fight the abuse or why there were aspects of the encounters they enjoyed. They suffer from a great deal of self-blame and guilt for not fighting or trying to get help; they feel ashamed.

Additional Case Studies for Chapter 7 1. Bryn Ostrager outlines a three tiered response to teen sexting. He then presents three case studies and guides the ready to apply the three-tiered system to each

case. In addition to discussing the cases, students can talk about the three-tiered system.

Ostrager, B. (2010). SMS. OMG! TTYL: Translating the law to accommodate today’s teens and the evolution from texting to sexting. Family Court Review, 48 (4), 712-726. https://doi.org/10.1111/j.1744-1617.2010.01345.x

2. The web site, Creating Safer Havens links to articles many articles on recent sexual abuse cases. The cases are categorized as: church, teacher, coaches, daycare, pediatrician/therapist, and other. They can be found at http://creatingsaferhavens.com/. Click on the link “Child Sexual Abuse Cases.”

3. This web link is to case studies of two people, Margaret and Rob who survived child sexual abuse and thrived and to the case of Mike who sexually abused his step-daughter (5 pages long). https://www.cascw.org/wpcontent/uploads/2013/12/Select-Illustrative-Case-Studies.pdf 4. This article provides research on the public response to the case of pediatrician who victimized children.

Abstract: Popular discourse provides a window into predominant social beliefs. To assess predominant beliefs about child sexual abuse, this exploratory, descriptive study examines the discourse surrounding a high-profile child abuse case that involved over 100 victims and culminated in the arrest of a well-known Delaware pediatrician in 2009. The Dr. Earl Bradley case, dominated local news media for more than a year. Online comments from the state's primary newspaper were collected and analyzed to identify themes. Coding analysis found that popular discourse overwhelmingly explained the abuse as the fault of the victims' parents, putatively, the mothers. Commenters engaged in direct blaming of parents, thus, at least to some extent, shifting blame from the offender and the institutional systems that failed to adequately react to the allegations of abuse to the victims' parents. Newspaper comments also demonstrated social distancing which, in addition to the comments attributing blame to the parents, served to excuse and distract from the responsibility of authority figs. or structural change. Although comments that defended parents did appear, these instances were far less frequent than comments blaming the parents, which illustrates a trend to individualize rather than activate collective challenges, therefore putting the onus on victims to police the powerful. Overall, institutional malfeasance eclipsed the well-being of children, and public commentary displayed an implicitly gendered parent-bashing, diminishing the responsibility of the professionals.

Miller, S. L., Hefner, M. K., and Leon, C. S. (2014). Diffusing responsibility: A case study of child sexual abuse in popular discourse. Children and Youth Services Review, 37, 55-63. https://doi.org/10.1016/j.childyouth.2013.12.005

5. Children & Family Health posted a brief case study of a 12 year old girl who was sexually abused by a family friend. They note what problems the child was having and what was done to help her. Written at a level that is appropriate for a child.

Discuss what impact this information might have on child victims. Would it be helpful? https://childrenandfamilyhealthdevon.nhs.uk/camhs/case-studies/childsexual-abuse-case-study/ 6. This 2018 case study presents the physical consequences of CSA and the failure of the medical community to provide appropriate services. The information is based on 7 interviews with a female victim of severe CSA.

Abstract: Stressful early life experiences cause immune dysregulation across the lifespan. Despite the fact that studies have identified childhood sexual abuse (CSA) survivors as a particularly vulnerable group, only a few attempts have been made to study their lived-experience of the physical health consequences of CSA. The aim of this study was to explore a female CSA survivor’s lived-experience of the physical health consequences of CSA and how she experienced the reactions of healthcare providers. Seven interviews were conducted with this 40-year-old woman, Anne, using a phenomenological research approach. Anne was still a young child (two to three years old) when her father started to rape her. Since her childhood, she has experienced complex and widespread physical health consequences such as repeated vaginal and abdominal infections, widespread and chronic pain, sleeping problems, digestive problems, chronic back problems, fibromyalgia, musculoskeletal problems, repeated urinary tract infections, cervical dysplasia, inflammation of the Fallopian tubes, menorrhagia, endometrial hyperplasia, chlamydia, ovarian cysts, ectopic pregnancies, uterus problems, severe adhesions, and ovarian cancer. Anne disclosed her CSA experience to several healthcare providers but they were silent and failed to provide traumainformed care. Anne’s situation, albeit unique, might reflect similar problems in other female CSA survivors. file:///C:/Users/Jud/Downloads/ijerph-15-00094-v2.pdf 7. This web link lists 11 case studies of children involved in child sexual abuse including online grooming, gangs, peer pressure, running away, and trafficking.

Each case study is 1 or 2 pages long. https://www.parliament.scot/S4_PublicPetitionsCommittee/Inquiries/CSE__Barnardos_Scotland_22.11.13.pdf

Video Suggestions 1. Law and Order: Special Victims Unit Season 13, episode 2 is entitled “Personal Foul.” It deals with allegations of sexual abuse against a famous basketball coach.

It originally aired on Sept. 28, 2011. It will certainly spark discussion of the recent Penn State case. The episode is available from Amazon.com for $2.99.

2. Boys and Men Healing from Childhood Sexual Abuse is a Big Voice Pictures Production. It is available from $9.99 from https://gumroad.com/l/boysandmenhealing From their website: Boys and Men Healing is a documentary about the impact male child sexual abuse has on both the individual and society, and the importance of male survivors healing and speaking out for the well being of individuals, families, and communities. This film digs deep into the effects of boyhood sexual abuse-shame, intimacy problems, sexual identity confusion, post-traumatic stress, depression, substance abuse, the cycle of violence and anger that plagued their lives--yet each man ultimately chose the arduous task of healing. Through counseling and support groups and taking action toward the prevention of other boys, each man is a testimony of hope and the ability for survivors to thrive. The film bursts forth with beauty and celebration of men’s emotions and voices—too long veiled under masculinity stereotypes and silence. NOTE: *Viewing films are for personal use and for in-house, non-fee based training use only. For fee-based and public trainings, contact copyright holder, Big Voice Pictures, for educational and public performance licensing.Email kathy@bigvoicepictures.com for licensing info.)

3. This 4:48 minute video clip is available on youtube. It is entitled Brian on the Oprah Show and it was uploaded November 18, 2010. The clip deals with the impact of child sexual abuse on male victims. http://www.youtube.com/watch?v=S1fugttyvZk 4. This 3:18 minute video clip is available on youtube. Dr. Phyllis Gee appears on the show Crimes Against Kids Eliminated to discuss the symptoms and signs of child sexual abuse. The clip was uploaded on Oct. 19, 2010. http://www.youtube.com/watch?v=63a-rU0DbOI 5. This 2:13 minute video clip is available on youtube. Erin Merryn, a victim of sexual abuse and the author of Stolen Innocence and Living for Today is profiled on the Oprah Winfrey Show. http://www.youtube.com/watch?v=nxOUMbj8Egw 6. This 1:53 minute video clip is available on youtube. The clip was produced by NY Daily News and is entitled Third Child Sexual Abuse Claim Made Against Elmo Puppeteer. The video was uploaded Nov. 27, 2012 and would be good for discussions about grooming victims. http://www.youtube.com/watch?v=JsEOInE2NZE 7. This 3:38 minute video is available on youtube. The video is produced by a college station, TYT University for Rust College. The clip is entitled Sexual Assault by “Teacher of the Year?” and was aired on Oct. 31, 2012. While the production is

not overly professional, it does show college students grappling with allegations that a well-respected professor raped a student who came to him for counseling about financial aid. http://www.youtube.com/watch?v=XdiO7c2NbQU 8. This 23 minute WRAL documentary, The Horrors of Child Sexual Assault and Abuse – “Speaking the Unspeakable,’ tells the stories of two male survivors. https://www.youtube.com/watch?v=vnk0QC1BPOs The video was posted on July 25, 2019.

9. This 28 minute PBS documentary aired on 4-24-2012. It is titled Out of Darkness, Into Light: Child Sexual Abuse. It tells the story of 3 adult survivors of CSA. Discussion Topics 1. Singer, Hussy, and Strom (1992) present a letter written by a middle-aged man to teenaged boy. The letter was an attempt to groom/seduce the boy. The authors analyze the letter in light of the literature on grooming victims.

Singer, M. I., Hussey, D., & Strom, K. J. (1992). Grooming the victim: An analysis of a perpetrator’s seduction letter. Child Abuse & Neglect, 16, 877-886. https://doi.org/10.1016/0145-2134(92)90089-A 2. Have students look up their state’s definition of child sexual abuse. What do they like and dislike about the definition presented? What wording would they suggest to define sexual abuse?

3. The chapter does not deal extensively with child exploitation/pornography/prostitution because these crimes are most often perpetrated outside of the family. However, students might be interested in researching these topics and presenting their findings to the class.

4. Have students discuss what they will do to protect their current or future children from becoming the victims of sexual abuse.

5. Clancy’s claim that child sexual abuse is not usually traumatic is very controversial. Have students discuss the pros and cons of thinking about sexual abuse as not being traumatic when it occurs.

Chapter 8 - Fetal Abuse Test Items: 1. Based on data from the National Survey on Drug Use and Health, it is estimated that approximately of pregnant women used illicit drugs in the previous 30 days? a. 1% b. 3% c. 5% d. 10% Answer: C 2. The Us. Department of Health and Human Services estimated that fetuses are exposed to substances each year in the United States. a. 250,000 b. 500,000 c. 1,000,000 d. 3,000,000 Answer: C 3. Fetal Alcohol Syndrome is a. not linked with intellectual disability b. one of the leading, preventable causes of intellectual disability c. most commonly linked to severe intellectual disability (IQ less than 45) Answer: B 4. Dysmorphic features, including a flat nasal bridge is associated with prenatal exposure to a. Alcohol b. Marijuana c. Cocaine d. All of the above Answer: A 5. With regard to prenatal exposure to alcohol, the broadest term is: a. fetal alcohol spectrum disorders (FASD) b. partial FAS (pFAS) c. alcohol related birth defects (ARBD) d. alcohol related neurodevelopmental disorder (ARND) Answer: A 6. Which of the following is not associated with prenatal exposure to nicotine? a. Low birth weight b. Respiratory problems c. Sudden Infant Death Syndrome

d. All of the above are associated with prenatal exposure to nicotine Answer: D 7. Prenatal exposure to appears to have the most dire consequences of all forms of prenatal substance abuse. a. alcohol b. over-the-counter drugs c. illegal drugs d. cigarettes Answer: A

8. Which case involved charging a woman with delivering drugs to a minor through the umbilical cord? a. State v. Whitner b. State v. McKnight c. State v. Johnson d. People v. Stewart Answer: C 8. Which case marked the first time a woman was charged with child abuse for drug use during pregnancy? a. State v. Pfannenstiel b. State v. Whitner c. State v. McKnight d. State v. Johnson Answer: A 9. Pameala Rae Stewart was charged with failure to deliver support to her child while she was pregnant (she did not avoid drugs, or intercourse, nor did she stay off her feet as ordered). What was the court’s decision? a. Stewart was found guilty of homicide by child abuse. b. Stewart was found guilty of child neglect. c. Stewart was found guilty of child endangerment. d. The case was dismissed.

Answer: D 10. Cornelia Whitner’s son was born with cocaine metabolites in his system. She pled guilty to a. negligent homicide b. manslaughter c. criminal child neglect d. child physical abuse Answer: C 11. Which of the following women was found guilty of homicide by child abuse?

a. Johnson b. Stewart c. Whitner d. McKnight Answer: D 12. Charles and Shivas argue that the motivation for the prosecution of fetal abuse a. is soley based on concern for the child b. may be about attacking the mother’s character c. is the same regardless of what endangers the fetus (drugs or high-order multiple births) Answer: B

True/False 1.

Maternal depression increases the risk for fetal abuse.

Answer: True 2.

Cocaine has more negative effects on fetal development than does alcohol.

Answer: False 3.

The effects of cocaine on the developing fetus were initially overestimated by researchers and the media.

Answer: True 4.

Cocaine has no negative effects on fetal development.

Answer: False 5.

The number of women who smoke while pregnant seems to be declining in the last 15 years.

Answer: True 6.

If a heroin addict uses methadone instead of heroin during pregnancy, their fetus will develop normally.

Answer: False 7.

Buprenorphine is thought to be a safer treatment for pregnant women who are addicted to heroin than is methadone.

Answer: True 8.

Buprenorphine has no negative effects on the fetus.

Answer: False

9.

There is a serious shortage of treatment programs available for pregnant women who are addicted to drugs.

Answer: True 10.

Doctors in all U.S. states are mandated to report pregnant women who use substances to Child Protective Services.

Answer: False 11.

There is significant public support for the criminal prosecution of pregnant women who use drugs.

Answer: True 12.

If a child is prenatally exposed to drugs, they are at an increased risk for being maltreated after they are born.

Answer: True

Short Answer Questions: 1. List five possible causes for fetal abuse.

Answer: Any 5 of these: Addiction Depression Mixed feelings about pregnancy Problems in interpersonal relationships History of drinking alcohol before pregnancy History of being abused or being exposed to violence Low education levels Teen mothers who felt “pushed around” Rarely – perception that the fetus is attacking or depriving the mother 2. Why is it difficult to determine the impact of a drug on fetal development?

Answer: First, many people are polydrug users, so it is difficult to determine the effect on any one drug. Second, drug use during pregnancy often occurs along with other things that are not ideal for fetal development (e.g., poor nutrition, poverty, homelessness, minimal prenatal care). Third, the impact of any drug may be different depending on when during the pregnancy the mother uses that drug.

3. What is fetal alcohol syndrome?

Answer: a series of birth defects resulting from a mother’s consumption of alcohol during pregnancy. Symptoms include intellectual disability, low birth weight, head and face abnormalities, and growth deficiencies 4. Select ONE of the drugs covered in the text, and describe the impact it has on the fetus.

Answers will vary.

5. What racial problem is associated with mandatory reporting of positive drug screens on newborns?

Answer: There is a concern about racial discrimination: minorities have been tested and reported at a higher rate than are Caucasians.

6. What is meant by “civil commitment”?

Answer: the confinement of a person who is ill, incompetent, or addicted to drugs Additional Case Studies for Chapter 8 1. The article Outcry in America as Pregnant Women Who Lose Babies Face Murder Charges by Ed Pilkington (2011) can be found at http://www.guardian.co.uk/world/2011/jun/24/america-pregnant-women-murdercharges This article contains information about several cases: Rennie Gibbs, Bei Bei Shuai, and Amanda Kimbrough.

2. The article The Criminalization of Bad Mothers by Ada Calhoun (2012) can be found at http://www.nytimes.com/2012/04/29/magazine/the-criminalization-ofbad-mothers.html?pagewanted=all This article contains information about the cases of Amanda Kimbrough, Heather Capps, and Hope Ankron.

3. The article Idaho Woman Arrested for Abortion is Uneasy Case for Both Sides by Jessica Robinson (2012) can be found at http://www.npr.org/templates/story.php?storyId=150312812 This articles describes the case of Jennie Linn McCormack who was arrested and charged with using RU-486 to terminate her pregnancy after 9 weeks of pregnancy.

4. Mackenzie et al. (1982) present the case study of a 34 year old pregnant woman who engages in a number of risky behaviors. Although the fetus seems to be developing normally, the authors discuss the best interventions to ensure the continued health of the baby.

Mackenzie, T. B., Collins, N. M., & Popkin, M. E. (1982). A case of fetal abuse?

American Journal of Orthopsychiatry, 52(4), 699–703. https://doi.org/10.1111/j.1939-0025.1982.tb01459.x Video Suggestions 1. http://www.youtube.com/watch?v=X9ap3Iimimk This 14:50 minute video was produced by the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

It is entitled Fetal Alcohol Syndrome: The Biological Basis. The video includes interviews with adoptive parents of children with Fetal Alcohol Syndrome.

2. http://www.youtube.com/watch?v=m7zfJCW9Yco This 56:51 minute video is entitled Fetal Alcohol Spectrum Disorder (FASD). In this video, eight women describe how their use of drugs and/or alcohol during their pregnancies affected their children.

3. http://www.youtube.com/watch?v=vA4GfL-JvFE This 1:31 minute clip comes from NBC 4 News. The story tells of a program to train caregivers who work with infants who are prenatally exposed to drugs. The clip aired on November 24, 2010.

4. http://www.youtube.com/watch?v=dJt-mrZT6-Q This 3:53 minute video clip was produced by NBC News 3. It is entitled Drug Addicted Babies Part I. The story focuses on babies born addicted to opiates and/or prescription drugs. It first aired on May 17, 2012.

5. http://www.youtube.com/watch?v=Efwk-pZSzZU This 3:31 minute video shows a mother telling about the children she had while using cocaine – all of whom were and are totally healthy. She also speaks to the lack of treatment programs available for pregnant addicts. This was recorded April 24, 2009.

6. http://www.youtube.com/watch?v=kk2l5ZkOKK4 This webcast runs 1:42:54. It is titled, Substance Exposed Newborns: Identification, Referral and Treatment.

Four professionals from federally funded projects present their findings in a lecture/power point format. The webcast was recorded on Sept. 15, 2009.

7. https://drugabuse.com/alcohol/drinking-while-pregnant/ This short video clip (2 minutes 12 seconds) on Drinking and Pregnancy by DrugAbuse.com discusses the risks of using alcohol while pregnant. Discuss whether educational videos like this are likely to impact rates of prenatal exposure to alcohol. This video was posted on Nov. 24, 2018.

Discussion Topics 1. Encourage students to discuss whether responses to drug use during pregnancy are influenced by maternal race and/or social class. Have students read the following article: Springer, K. W. (2010). The race and class privilege of motherhood: The New York

Times presentations of pregnant drug-using women. Sociological Forum, 25 (3), 476-499. https://doi.org/10.1111/j.1573-7861.2010.01192.x 2. Brown et al. (2019) provide a fascinating look at the history of the link between alcohol consumption during pregnancy and negative fetal outcomes.

While acknowledging that the scientific link was established in the 1960s, they note links dating back to ancient history.

Brown, J. M., Bland, R., Jonsson, E., & Greenshaw, A. J. (2019). A brief history of awareness of the link between alcohol and fetal alcohol spectrum disorder.

The Canadian Journal of Psychiatry / La Revue Canadienne de Psychiatrie, 64(3), 164–168. https://doi.org/10.1177/0706743718777403

Chapter 9 – Munchausen Syndrome by Proxy Test Items: 1. The DSM-V does not use the term, Munchausen Syndrome by Proxy. Instead, the same types of behaviors are called: a. Making My Child Ill Mania b. Factitious Disorder Imposed on Another c. Post-Partum Psychosis d. Differential Identity Disorder by Proxy Answer: B 2. Who coined the term Munchausen Syndrome by Proxy? a. Sir Thomas Stevens b. Sir William Gates c. Sir Roy Meadow d. Sigmund Freud Answer: C 3. A mother who says her child had ten seizures, when only one seizure occurred, is guilty of: a. exaggerating b. fabricating c. inducing d. all of the above Answer: A 4. A caregiver who injects a non-diabetic child with insulin is guilty of: a. exaggerating b. fabricating c. inducing d. all of the above Answer: C 5. If a mother says that her infant stopped breathing and had to be resuscitated when this never happened, she is guilty of: a. exaggerating b. fabricating c. inducing d. all of the above

Answer: B 6. Which of the following is true with regard to false claims of illness or disability in an educational setting. a. unlike claims of physical illness, nobody is hurt by a false educational claim b. these claims are a hassle for the school district, but they do not impact the child c. these claims are very costly to school districts d. there have been no claims of MPS in an educational setting Answer: C

7. Which of the following is NOT true about MPS? a. victimization is usually short lived b. victims are usually infants and toddlers c. victims may suffer unnecessary pain as a result of the parent’s actions and/or medical procedures d. more than one child in a family may be a victim Answer: A 8.

are the most common victims of MPS. a. Adolescents b. Children in elementary school c. Infants and toddlers d. The elderly

Answer: C 9. Most perpetrators of Munchausen Syndrome by Proxy are: a. Fathers b. Mothers c. Babysitters d. Grandmothers Answer: B 10. The main motivation behind Munchausen Syndrome by Proxy appears to be: a. the sadistic desire to cause pain b. extreme dislike of the child c. getting attention d. a desire to have fewer children Answer: C 11. When Libow interviewed adult survivors of MPS, he found that a. They had no negative symptoms from their earlier victimization

b. When looking back at the abuse, none of the adults were aware, at the time, that anything was wrong c. Most of the adults had sought mental health help to deal with their victimization. d. Most of the adults had lasting physical problems, but they were well adjusted psychologically.

Answer: C 12. Which of the following is considered suspicious when evaluating a case for possible Munchausen Syndrome by Proxy? a. a mother who resists allowing further tests or procedures b. a mother who seems disinterested in the medical treatment c. a mother who is seen as shy and quiet d. a mother who does not appear to be relieved by good news Answer: D 13. Many mothers who are guilty of Munchausen Syndrome by Proxy have a background in: a. business b. law c. healthcare d. law enforcement Answer: C 14. Which of the following diagnoses would be appropriate for a case in which a child was being made ill by their caregiver, regardless of the caregiver’s motivation? a. Munchausen Syndrome by Proxy b. Pediatric Condition Falsification c. Malingering by Proxy d. Factitious Disorder by Proxy Answer: B 15. Which of the following diagnoses would be most appropriate for a mother who told everyone her child had cancer so that they would give her money to help pay for treatment? a. Munchausen Syndrome by Proxy b. Pediatric Condition Falsification c. Malingering by Proxy d. Factitious Disorder by Proxy Answer: C 16. The mortality rate associated with MPS is estimated to be a. less than 5% b. 6 to 10% c. 20 to 25% d. Over 30% Answer: B 17. According to Libow’s study, adult survivors of MPS tended to place blame on a. the non-offending parent who did not protect them b. the offending parent c. themselves d. all of the above

Answer: B 18. According to Libow’s study, most adult survivors of MPS indicated that a. had no long term effects from the maltreatment b. did not seek therapy to help themselves as a result of the maltreatment c. their experiences with MPS had a significant, negative impact on their adult life d. that they now engaged in MPS with their own children Answer: C 19. The mission of MAMA is to a. prevent Munchausen Syndrome by Proxy. b. fight false allegations of Munchausen Syndrome by Proxy. c. accuse doctors of Munchausen Syndrome by Proxy. d. fight to eliminate video surveillance Answer: B 20. Dr. Roy Meadow’s expert testimony was called into question due to his problems with: a. understanding the diagnosis of Munchausen Syndrome by Proxy b. his diagnosing a disorder he had named c. improper statistical testimony d. the fact that he was paid to provide testimony Answer: C 21. Restricting a parent’s access to a child when one suspects Munchausen Syndrome by Proxy generally requires a. a doctor’s note b. Child Protective Services intervention c. a court order d. The parent’s access cannot be restricted Answer: C 22. Which of the following is true with regard to the incidence of Munchausen Syndrome by Proxy? a. While Munchausen Syndrome by Proxy is rare, experts expect that the incidence may increase as professionals become more aware of the syndrome. b. Munchausen Syndrome by Proxy is one of the most common forms of child maltreatment c. Munchausen Syndrome by Proxy is less common than neglect, but more common than sexual abuse d. None of the above is true.

Answer: A

23. The Fourth Amendment to the U.S. Constitution protects citizens from a. having to testify against family members b. government interference with how they raise their children c. unreasonable search and seizure d. having to testify in cases where they are the defendant Answer: C 24. With regard to the age of victims with Munchausen Syndrome by Proxy, which of the following is accurate? a. All victims are under the age of 10 years b. 95% of victims are infants or toddlers c. Almost all victims are 5 years old or older d. Approximately 25% of victims are over the age of 6 years Answer: D 25. Which of the following is true regarding the study by Hall, Eubanks, Meyyazhagan, Kenny and Johnson (2000) using covert video surveillance? a. By videotaping the caregivers suspected of Munchausen Syndrome by Proxy, the authors were able to see that none of them were maltreating their children. b. Evidence of Munchausen Syndrome by Proxy was found in more than half of the suspected cases. c. The mothers who were abusive were almost all African American. d. The true victims of Munchausen Syndrome by Proxy were nearly all male children.

Answer: B

Short Answer Questions: 1. What is the relationship between the terms “Munchausen Syndrome by Proxy” and “Factitious Disorder Imposed on Another”?

Answer: Munchausen Syndrome by Proxy is the name that has been used to refer to cases in which a parent makes their child ill or claims the child is ill. It is derived from stories of Baron Munchausen who was alleged to have told many tall tales. In contrast, Fictitious Disorder Imposed on Another is the name for the same behaviors that appears in the DSM-V. 2. Give an example of exaggeration, one of fabrication, and one of inducing.

Answer: Many possible answers. As an example: Exaggeration – a child experiences sleep apnea once per hour and the parent claims it is 20 times per hour.

Fabrication – a parent claims that a child had seizures when there were no seizures Inducing – a mother forces her child to ingest castor oil until he vomits each day and then brings him to the doctor and claims he is not gaining weight.

3. List 5 perpetrator characteristics associated with MPS. Answer: Any 5 of these: - mothers -

present initially as “normal, good” caretakers

-

accomplished liars, deceivers; believable

-

have extensive health care knowledge

-

history of being abused themselves

-

more likely to suffer from a somatizing disorder, borderline personality disorder or depression

-

may add or change health care providers frequently

-

use their victims as objects to satisfy their need for attention

-

no prior CPS involvement

-

“dramatic flair”

-

history of symptom/illness falsification for themselves

4. Define Pediatric Falsification Syndrome Answer: Pediatric Falsification Syndrome is a proposed diagnosis that means only that a child is being made ill or described as ill when they are not. This diagnosis describes what is happening to the child, but does not speak to parental motivation.

5. List 5 possible outcomes associated with child victims of MPS Answer: Any 5 of these: - Pain and suffering from induced symptoms - Pain and suffering from medical tests - Permanent disability - Death - Psychological problems - Immaturity - Problems with Separation Anxiety - Irritable and/or aggressive - Attention Deficit Disorder - Post-Traumatic Stress Disorder (PTSD) - Poor school performance - Missed Social and Educational opportunities - Having siblings who are injured - Embarrassment or shame - Removal from the home - Child may develop Munchausen Syndrome 6. If you suspected that a child you were working with was the victim of MPS, what should you do first?

Answer: Carefully review the child’s file and then pull together and interdisciplinary team to discuss your suspicions. Try to involve every professional involved with the child’s case.

Additional Case Studies for Chapter 9 1. Clin, Ferrant, Dupont, & Papin (2009) present a detailed medical case of a 9-month-old girl who was poisoned by her mother resulting in recurrent caustic esophagitis. This three page reports details the infant’s hospitalization and includes a discussion and conclusions.

Clin, B., Ferrant, O., Dupont, C. & Papin, F. (2009). Recurrent caustic esophagitis: A clinical form of Munchausen syndrome by proxy. Child Abuse and Neglect, 33, 293-295. https://doi.org/10.1016/j.chiabu.2008.09.007

2. Rosenberg (1988) details a case (3 pages long) about a 9-year-old boy suffering from Munchausen Syndrome by Proxy. The author covers the boy’s hospitalizations, brief

descriptions of the mother and father, and describes the assessment and outcome.

Rosenberg (1988). Recent issues in child maltreatment. In The New Child Protection Team Handbook. Eds: D. C. Bross, R. D. Krugman, M. R. Lenherr, D. A. Rosenberg, & B. D. Schmitt. Garland Publishing, Inc.

3. Drs. Roesler and Jenny (2009) summarize 115 cases referred for possible MPS. They give brief case examples of 16 children (one paragraph each). Of the 115 cases, 87% met their criteria for medical child abuse. The authors then present the following data about

the 87 cases: Types of Unnecessary Medical Care Received, a Comparison of Children Found to Be Victims and Those Who Were Not, Medical Specialists Involved (e.g., gastrointestinal, psychiatric, neurological), Types of Treatment Given, and Interventions.

Roesler, T. A., & Jenny, C. (2009). Description of 115 cases referred for possible Munchausen Syndrome by Proxy. In T. A. Roesler, & C. Jenny (Eds.), Medical Child Abuse: Beyond Munchausen Syndrome by Proxy (pp. 131-154). American Academy of Pediatrics.

4. Ruth Kannai (2009) presents a four page case summary of a woman, Sarah, who was guilty of Munchausen Syndrome by Proxy. The victim was her fourth child, a daughter, Joy. The case covers Joy’s repeated hospitalizations and the reluctance of the family’s general practitioner to suggest Munchausen Syndrome by Proxy to the other doctors involved.

Kannai also provides some of the mother’s history. The case summary is followed by a four page discussion of the case.

Kannai, R. (2009). Medical family therapy casebook: Munchausen by mommy. Families, Systems, & Health, 27(1), 105-112. https://doi.org/10.1037/a0015031 Video Suggestions 1. The movie The Sixth Sense contains a scene (chapter 15 on the dvd) about a child who died as a victim of Munchausen Syndrome by Proxy. The main character in the movie is a young boy, Cole, who can see dead people and the ghost of a young girl, Kyra, uses him to reveal that she was a victim of Munchausen Syndrome by Proxy and that her younger sister is now at risk. The scene takes place during

Kyra’s memorial service and you overhear a number of comments that would point to Munchausen Syndrome by Proxy. Kyra than shows Cole a video she made of her mother poisoning her.

2. The show Munchausen Moms (2007) includes video of covert video surveillance of Munchausen Syndrome by Proxy cases. The video is 45 minutes long and is available for free on Amazon Prime (with ads); it can be rented for $1.99 or purchased for $7.99.

3. Numerous videos are available that cover the Gypsy Rose case – for example Gypsy’s Revenge and The Act are series that document the case while Mommy Dead and Dearest is a 1 hour and 22 minute movie produced in 2017. It is an HBO production that is available with HBP and HBO on Amazon.

Discussion Topics 1. A complex and difficult case type is the recurrent allegation of child sexual abuse that is unfounded. In these cases one parent, usually the mother, repeatedly presents the child for examination for alleged sexual abuse. There are either no medical findings, or findings that are not definitive for abuse. Assuming the mother does not seem to be alleging sexual abuse to gain attention, the case would not meet the criteria for Munchausen Syndrome by Proxy. However, repeated questioning and medical exams may have a negative impact on the child that is similar to that seen in Munchausen Syndrome by Proxy. The mother’s motivation may be to gain custody, true concern about sexual abuse, a desire to hurt the alleged perpetrator, or a combination of these. It has been suggested that a new label, ‘recurring sexual abuse allegations’ be used for these cases (Lindahl, 2009).

a. What are the similarities and differences between Munchausen Syndrome by Proxy and recurring sexual abuse allegations?

b. How important is the mother’s motivation to determining a diagnosis? c. Discuss the use of the label malingering by proxy in relation to recurring sexual abuse allegations.

2. Schreier and Libow (1994) list 13 guidelines for suspecting and identifying MPS (in a Table on page 111). For some, or all, of the 13 guidelines have students argue that a normal, non-abusive situation might entail the same behavior: Table 1. Guidelines for suspecting and identifying MBPS 1. A child who has one or more medical problems that do not respond to treatment or that follow an unusual course that is persistent, puzzling, and unexplainable 2. Physical or laboratory findings that are highly unusual, discrepant with history, or physically or clinically impossible 3. A parent (usually the mother) who appears to be medically knowledgeable and/or fascinated with medical details and hospital gossip, appears to enjoy the hospital environment, and often expresses interest in the details of other patients’ medical problems 4. A highly attentive parent who is reluctant to leave her child’s side and who herself seems to require constant attention 5. A parent who appears to be unusually calm in the face of serious difficulties in her child’s medical course while being highly supportive and encouraging of

the physician, or one who is angry, devalues staff, and demands further intervention, more procedures, and the like 6. The suspected parent may work in the health care field herself or profess interest in a health-related job 7. The signs and symptoms of a child’s illness do not occur in the parent’s absence (hospitalization and careful monitoring may be necessary to establish this causal relationship) 8. A family history of unusual or numerous medical ailments that has not been substantiated and raises questions about the reporter’s veracity 9. A family history of similar sibling illness or unexplained sibling illness or death 10. A parent with symptoms similar to her child’s own medical problems or an illness history that itself is puzzling and unusual 11. A suspected parent with an emotionally distant relationship with her spouse; the spouse often fails to visit the patient and has little contact with physicians even when the child is hospitalized with serious illness 12. A parent who reports dramatic, negative events, such as house fires, burglaries, car accidents and the like, that affect her and her family while her child is undergoing treatment 13. A parent who seems to have an insatiable need for adulation or who makes self-serving efforts at public acknowledgement of her abilities (Schreier & Libow, 1994, p. 111 – as modified from Schreier & Libow, 1993)

Schreier, H. A., & Libow, J. A. (1994). Munchausen by Proxy Syndrome: A modern pediatric challenge. The Journal of Pediatrics, 125(6), 110-115. https://doi.org/10.1016/S0022-3476(05)82934-8

Chapter 10 – Resilience Test Items 1. Which of the following is true of resilient people? a. They do not experience negative emotions b. They can experience positive emotions even during difficult times c. They rarely experience positive emotions d. None of the above are true Answer: B 2. Which of the following is true of resilient people? a. They seem not to have a fight or flight response b. They always chose to fight rather than flee c. They always chose to flee rather than fight d. They react appropriately to stress and then return to normal functioning when threat has passed Answer: D 3. Which of the following is associated with positive emotions? a. Lower blood pressure b. Decrease in physiological arousal c. Feelings of safety d. All of the above Answer: D 4. Which 14-item test was designed to measure how well a person can adapt their behavior to meet the demands of changing situations? a. Child and Youth Resilience Measure b. Child Behavior Checklist c. Ego-Resiliency Scale d. Trauma Symptoms Checklist for Children Answer: C 5. What is the name of the 28-item test designed to assess the level of support a person has to be resilient across individual, relational, community and cultural domains? a. Child and Youth Resilience Measure b. Child Behavior Checklist c. Ego-Resiliency Scale d. Trauma Symptoms Checklist for Children Answer: A 6. Which test requires parents and teachers to assess a child’s behavior and emotional functioning?

a. Child and Youth Resilience Measure b. Child Behavior Checklist c. Ego-Resiliency Scale d. Trauma Symptoms Checklist for Children Answer: B 7. Which of the following statements about resiliency is true? a. At least 50% of maltreated children are resilient when resiliency is measured across several domains. b. Between 16 and 35% of maltreated children are resilient when resiliency is measured across several domains. c. On average, males are more likely to be resilient following maltreatment than are females. d. Resiliency does not change over time – once resilient, always resilient.

Answer: B 8. What did Liem, James, O’Toole and Boudewyn (1997) find about the differences between resilient and non-resilient sexual abuse victims? a. The abuse started earlier for the non-resilient group b. The abuse started later for the non-resilient group c. The perpetrator was a family member more often for the non-resilient group d. Physical force was used more often with the non-resilient group Answer: D 9. Which parenting style is most strongly associated with resiliency? a. Authoritative b. Authoritarian c. Permissive/Indulgent d. Neglectful Answer: A 10. Which temperament is associated with resiliency? a. Difficult b. Easy c. Slow-to-warm-up d. None of the above Answer: B 11. Which of the following is true regarding the research findings on intelligence and resiliency? a. Intelligence is always positively associated with resiliency b. Intelligence is never associated with resiliency

c. The findings are inconsistent d. None of the above Answer: C 12. Which of the following is NOT associated with resiliency following sexual abuse? a. Discussing the abuse b. Minimizing the abuse experience c. Reframing the abuse in a more positive way d. Dwelling on the abuse Answer: D 13. Which of the following children would be most at risk for developing depression following child maltreatment? a. Jenny, who has two long alleles for the 5-HTT gene b. Sally, who has one long allele and one short allele for the 5-HTT gene c. Beth, who has two short alleles for the 5-HTT gene d. All three girls would be equally likely to develop depression Answer: C 14. Which of the following children is the most likely to be resilient following child maltreatment? a. Jenny, who has two long alleles for the 5-HTT gene b. Sally, who has one long allele and one short allele for the 5-HTT gene c. Beth, who has two short alleles for the 5-HTT gene d. All three girls would be equally likely to develop depression Answer: A

True/False 1.

If a child is resilient after maltreatment, it means the perpetrator is not guilty of a crime.

Answer: False 2.

Resilient children do not experience negative emotions.

Answer: False

3.

People who are resilient experience positive emotions even during difficult times.

Answer: True

4.

People who suffer less extreme forms of maltreatment are more likely to be resilient than those who suffer from more extreme maltreatment.

Answer: True 5.

Males are more likely to be resilient following child maltreatment than are females.

Answer: False 6.

Resilient adults tend to have an external locus of control.

Answer: False

7.

Having two short alleles for the 5-HTT gene decreases the chances that you will be resilient following child maltreatment.

Answer: True Short Answer Questions 1. Define resiliency.

Answer: resiliency is being able to recover easily from difficult circumstances; the ability to bounce back and persevere; being able to adjust to misfortune; adaptable 2. List 3 things you should do when attempting to measure resiliency.

Answer: 1. Measure at different times as resiliency may change across the lifespan. 2. Measure across various domains. 3. Collect information from multiple reporters 3. List 2 factors that cause incidence rates for resiliency to vary across studies.

Answer: 1. The way resiliency is defined impacts resilience rates. The big question is whether the absence of pathology or above average functioning constitutes resiliency. 2. Rates of resiliency vary based on how many factors are assessed. As the number of factors assessed increases, the rate of resiliency found decreases.

4. Describe three mechanisms by which a supportive adult may help a child be resilient.

Answer: 1. A stable, caring adult may allow the child to build a sense of trust in others and the belief that they will receive help when they need it. 2. Being cared for may increase the child’s sense of worth and thereby lead to resiliency. 3. A caring adult may reverse the negative neurobiological changes associated with experiencing adverse situations.

5. List five community factors that are associated with resiliency.

Answer: Any 5 of these: good schools, high quality social services, good health care services, prosocial clubs, religious organizations, libraries, recreation centers, or good public safety.

6. Why might religion and/or spirituality be positively associated with resiliency?

Answer: Spirituality may provide meaning for victims and assure them of their worth despite what they have experienced. Participation in organized religion may also increase the amount of social support available.

Additional Case Studies 1. Murphy (2009) presents a 7 page case study about a middle aged man named Mac with a history of child abuse. Murphy explains the maltreatment and how Mac’s negative symptoms are reduced after taking part in client-centered therapy.

Murphy, D. (2009). Client-centered therapy for severe childhood abuse: A case study.

Counseling and Psychotherapy Research, 9 (1), 3-10. doi: 10.1080/14733140802655992 2. Herrenkohl, Herrenkohl, and Egolf (1994) present a one page case study about three siblings who are the victims of child maltreatment. Two of the children are doing well and one is struggling. The authors then address protective factors and discuss the case in terms of the interaction between personal factors and the environment.

Herrenkohl, E. C., Herrenkohl, R. C., & Egolf, B. (1994). Resilient early schoolage children from maltreating homes: Outcomes in late adolescence. American Journal of Orthopsychiatry, 64 (2), 301-309.

Video Suggestions 1. The Unloved is a British television movie (1 hr 49 min.) about a resilient 11-yearold girl who is the victim of abuse at the hands of her father and who then enters a children’s home. The movie was first broadcast on May 17, 2009. It is available from Amazon for $11.93.

2. Post-Trauma Wellness (release March 20, 2012). This video has a lecture format and presents the work of the Center for Post Trauma Wellness. Their focus in on the recover from abuse. This dvd is available from Amazon for $19.95.

3. This 3:20 minute video clip is available on youtube. Dr. Yo Jackson of the University of Kansas talks about studying resiliency in children. The clip was uploaded on Sept. 29, 2009. Dr. Jackson defines resiliency, discusses how she plans to assess resilient children, and her hopes for the results.

http://www.youtube.com/watch?v=JNimix56mHM 4. This 9:38 minute video clip is available on youtube. Barbara Walters interviews Ellen DeGeneres (2007). The clip, Ellen DeGeneres (Sexual Abuse, Phone Call to God, Coming Out) reviews Ellen’s successful career, her experience with sexual abuse by her step-father and her coming out about her sexuality. http://www.youtube.com/watch?v=U-3S7jVBBG4 5. This 4:55 minute video clip is available on youtube. Naomi and Wynnona Judd speak out about their experiences with childhood sexual abuse in the hopes of helping others. The video was uploaded on April 7, 2011. The video was part of the Oprah Winfrey Show (ABC). http://www.youtube.com/watch?v=Ha47I2OiKB4 6. This 10:38 minute video clip is available on youtube. Jim Cantelon interviews Maury Blair about his abuse history, how he has overcome his experiences, and how he helps others. The video was uploaded September 21, 2010. Maury Blair is the author of the book Child of Woe. http://www.youtube.com/watch?v=Nmq6JFzQ4Zk 7. Derek Clark was the victim of child abuse. He then spent 13 years in foster care.

Today, he is a successful motivational speaker. At his website http://www.iwillnevergiveup.com/ You can find links to 6 video clips where he uses his experiences to help others.

Discussion Topics 1. Have the students research a famous person who suffered child maltreatment and seems to be resilient. What protective factors did/does this person have that helped them succeed despite negative life experiences?

2. Among people who are resilient following child maltreatment, some dedicate a great deal of time and/or money to helping other victims. What do you think makes some people chose this course of action? What is their motivation?

3. Is it valuable for celebrities to speak publically about their own maltreatment? It what ways might it be helpful? It what ways might it be harmful?

4. Which factors do you think are most important for resiliency? Do you think caregiver, community, victim, or genetic factors have the greatest impact on resiliency?

Chapter 11 - Forensic Interviewing of Children Test Items 1. The goal of forensic interviewing is to elicit information to be used a. for treatment purposes b. for prevention programs c. in legal settings d. all of the above Answer: C 2. The Federal Rule of Evidence 601 a. abolished the competency rules for witnesses b. said that children could not provide uncorroborated testimony in court c. ruled that children were not competent to provide testimony in court d. expanded hearsay testimony allowances Answer: A 3. In a legal context, uncorroborated testimony is testimony that is a. almost certainly false b. not supported or confirmed by additional evidence c. almost certainly true d. offered by multiple witnesses Answer: B 4. Which of the following is NOT associated with children providing accurate testimony? a. Spontaneous accounts b. Responding to unbiased questions c. Responding to open-ended questions d. A significant amount of time passing between the event and the telling so that memories have the chance to fully form Answer: D 5. Which of the following questions is open-ended and unbiased? a. How old are you? b. Did something bad happen at daycare? c. What happened when you stayed at your uncle’s house? d. Can you tell me what Mr. Jones did to upset you?

Answer: C 6. When researchers told children a story about a child who ate eggs and got a stomach ache and then later gave some of the children misleading information (e.g., Do you remember the story about Loren who had a headache because she ate her cereal too fast?), what happened when children were asked to select which picture had been in the story?

a. All of the children picked the accurate picture. b. Children who were misled made more errors than children who were not misled c. It was more difficult to mislead the younger children than the older children d. There were no age differences in error rate among the misled children Answer: B 7. Rudy and Goodman’s (1991) study where children dressed as a clown with a man who was a stranger to them found that a. Older children gave less correct information than did younger children b. Observers were more resistant to suggestion than were participants c. Children made very few errors that would be relevant in the assessment of abuse allegations d. Older children were more suggestible than younger children Answer: C 8. In interviewing children, which age group has special deficiencies (limited response in free recall, deference to adults, and problems with source monitoring) that make them vulnerable to suggestion through coercive questioning? a. Preschool children b. Elementary School aged children c. Adolescents Answer: A 9. Ceci et al. (1994) asked children the same question repeatedly. They found that a. Children were remarkably consistent about their answers b. More than half of the children assented to at least one false event. c. Children were willing to lie, but did not believe their false stories d. None of the above Answer: B 10. Failing to mention that something happened is a(n) a. Omission b. Commission c. Both an omission and a commission error. d. Neither an omission nor a commission error Answer: A

error.

11. Saying that something happened when it did not occur is a(n) a. Omission b. Commission c. Both an omission and a commission error. d. Neither an omission nor a commission error Answer: B

error.

12. The understanding that one thing can be two things at once is a. Metacognition b. Double thinking c. Dual representation d. Present at birth Answer: C 13. Research by DeLoache and Marzolf (1995) showed that children do not seem to understand dual representation until they are a. 18 months old b. 24 months old (2 years) c. 36 months old (3 years) d. 48 months old (4 years) Answer: D 14. If an interviewer’s beliefs about what happened impact the questions they ask and this leads to the child providing information that is false, but consistent with those beliefs, what has occurred? a. A self-fulfilling prophecy b. A clear establishment of rapport c. A good forensic interview Answer: A 15. A feeling of connection or trust between an interviewer and a child is called a. A coercive interview b. Rapport c. Interviewer bias d. A clumsy interview Answer: B 16. What was the main finding of the Sam Stone study? a. Children are very attentive to clumsy behavior b. Children’s memory is effected by negative information they hear about a person before they meet them; even if the person behaves appropriately in their presence c. Even young children form their own impressions; they are not swayed by negative stereotypes d. Older children are more influenced by negative stereotypes than are younger children Answer: B 17. According to Wood and Garven, an interview style that is likely to elicit false information should be called a(n) a. clumsy interview b. improper interview c. coercive interview

Answer: B

18. According to Wood and Garven, an interview style that is not likely to lead to false allegations, but that is conducted poorly is a. clumsy interview b. improper interview c. coercive interview Answer: A

19. What is the term used for special centers where carefully trained forensic interviewers conduct interviews, doctors do forensic medical exams, and therapists conduct therapy sessions for allegedly abused children? a. Children’s Police Stations b. Children’s Hospitals c. Child Advocacy Centers d. Centers for Abuse Recognition Answer: C

True/False 1.

It is harder to get a child’s testimony into court now than it was during the 1970s.

Answer: False 2.

According to Federal Rule of Evidence 601, all witnesses are presumed competent.

Answer: True 3.

There is general agreement that it is appropriate to use anatomically detailed dolls as anatomical models.

Answer: False 5.

Psychiatrists who observed children playing with anatomically detailed dolls were able to correctly determine whether the children had been sexually abused about 85% of the time.

Answer: False Short Answer Questions 1. Under what conditions would you be confident about the accuracy of a child’s testimony?

Answer: I would be confident in the accuracy of a child’s testimony if they told about the event spontaneously and after a minimum delay. I would also be confident if they had been asked only open-ended and non-biased question and if interviewers had avoided repeating questions.

2. What did Bruck et al. discover about children’s interactions with anatomical dolls?

Answer: Bruck discovered that when anatomical dolls were used, over 50% of children made false statements/demonstrated false events about what had occurred during a visit to the doctor if they were asked repeated, suggestive questions.

3. What is meant by the phrase “self-fulfilling prophecy”?

Answer: Social psychologists use the term self-fulfilling prophecy to refer to the process by which one person’s expectations about another person will actually lead that other person to behave in the expected way.

4. Identify 5 errors in the following interview (there are more than that!) between an investigator and a 3-year-old child: C = child I = Investigator Child enters room.

I: You may have a seat here. (Gestures to chair). Thank you for coming in to talk to me today. I understand that some bad things have happened to you.

C: (Shrugs. Nods yes.)

I: Can you tell me who hurt you.

C: Yes. I: Who was it that hurt you?

C: Joe. I: I want to talk to you about how Joe hurt you. Did Joe touch your bottom?

C: No. I: You don’t have to be embarrassed. You can tell me about what happened. You did not do anything wrong.

C: Okay.

I: Did Joe touch your bottom?

C: Yes. I: He did. Did that make you feel bad?

C: (Shrugs.)

I: I need for you to talk to me. We can’t make sure Joe goes away if you don’t talk to me.

C: Can I go home?

I: First we have to talk, than you can go home.

C: Okay.

I: Tell me how Joe made you feel bad.

C: He touched me.

I: Can you show me on this doll how he touched you?

C: (nods yes)

I: (Hands child a male, child doll. The doll is naked and anatomically correct.)

C: (Handles doll, puts finger in the child’s anus.)

I: Is that what Joe did to you?

C: Yes. I: Did he put his finger in your bottom or his penis?

C: Yes. I: He put his penis in your bottom. Did that hurt a lot?

C: (Shrugs).

Answer: Mistakes are noted in bold type.

Child enters room.

I: You may have a seat here. (Gestures to chair). Thank you for coming in to talk to me today. I understand that some bad things have happened to you. Does not build rapport. Suggestive “bad things.”

C: (Shrugs. Nods yes.)

I: Can you tell me who hurt you. Suggestive – implies someone hurt the child.

C: Yes. I: Who was it that hurt you?

C: Joe. I: I want to talk to you about how Joe hurt you. Did Joe touch your bottom? Suggestive.

The child has not said anything about bottoms.

C: No. I: You don’t have to be embarrassed, you can tell me about what happened. You did not do anything wrong. Suggestive – the child did not say he was embarrassed.

C: Okay.

I: Did Joe touch your bottom? Repeated question.

C: Yes. I: He did. Did that make you feel bad? Suggestive – “bad.”

C: (Shrugs.)

I: I need for you to talk to me. We can’t make sure Joe goes away if you don’t talk to me.

C: Can I go home?

I: First we have to talk, then you can go home. Coercive.

C: Okay.

I: Tell me how Joe made you feel bad. Suggestive – the child has not said that Joe made him feel bad.

C: He touched me.

I: Can you show me on this doll how he touched you?

C: (nods yes) I: (Hands child a male, child doll. The doll is naked and anatomically correct.)

C: (Handles doll, puts finger in the child’s anus.)

I: Is that what Joe did to you? Requires dual representation; child this age will not be able to do this.

C: Yes.

I: Did he put his finger in your bottom or his penis? Multiple choice question that may not include a correct answer.

C: Yes. I: He put his penis in your bottom. Did that hurt a lot? Suggestive “hurt”. The child said nothing about pain.

C: (Shrugs).

5. List 3 three things an interviewer should take into account when interviewing a child who is an immigrant.

Answer: Any 3 of these: Make sure to conduct the interview in the preferred language of the child Make sure to appreciate cultural differences Be aware that children of different cultures develop competencies at different ages Take a full trauma history 6. What is a practice interview?

Answer: A practice interview is when a forensic interviewer asks a child about a neutral, non-abuse related event before talking about the alleged abuse. This allows time for rapport building and to assess the child’s language ability and narrative style.

Additional Case Studies 1. Bidrose and Goodman (2000) present a scientific case study of memory for child sexual abuse. They present a case where four victims gave testimony that was then compared to video tapes made by the perpetrator. This case allows for a unique assessment of the accuracy of children’s testimony about sexual abuse.

Bidrose, S., & Goodman, G. S. (2000). Testimony and evidence: A scientific case study of memory for child sexual abuse. Applied Cognitive Psychology, 14, 197213. https://doi.org/10.1002/(SICI)1099-0720(200005/06)14:3<197::AIDACP647>3.0.CO;2-6 2. This four page case study follows a child sexual abuse case from the forensic interview to the victim impact statement. It is available at: https://www.jscimedcentral.com/Forensic/forensic-4-1047.pdf Meyer, G. & Mukherjee, D. (2017). The story of Lee: A case study highlighting the multidisciplinary team model of child sexual abuse cases: From forensic interview to the vicimt impact statement in court. Annals of Forensic Research and Analysis, 4(3), 1047-1050.

Video Suggestions

1. Indictment – The McMartin Trial (1995), produced by HBO and Oliver Stone, tells the story of the McMartin sexual abuse trial. Note: the film is rated R. It is available from Amazon.com for $14.47.

2. This video clip (1:51) uploaded by the Children’s Advocacy Center of Texas discusses the purpose of forensic interviewing in cases of alleged child abuse. https://www.youtube.com/watch?v=Q2rehYoMtRU 3. This YouTube video is a 27 minute in service training. Heather Smith of a Children’s Advocacy Center talks about forensic interviewing and what advocacy centers do for maltreated children. https://www.youtube.com/watch?v=FyexxmtDNOU&feature=related 4. This YouTube video is entitled The Reasons Forensic Child Sexual Abuse Interviews Fail (False Disclosure). Lawrence Daly, a forensic interviewer goes over six mistakes that interviewers make. The video clip is 6 minutes and 21 seconds. https://www.youtube.com/watch?v=FylkOaaAc9s 5. This YouTube video is a short news clip (2 minutes) produced by WISC-TV, News 3. The story covers forensic interviewing at Safe Harbor Children’s Advocacy Center. https://www.youtube.com/watch?v=SDq7PanmqtA 6. This YouTube video presents a lecture given by John E. B. Myers a law professor and leading researcher on legal issues in child maltreatment. It is a long video (58:27) and it covers many legal issues. He begins talking about forensic interviewing at minute 29. https://www.youtube.com/watch?v=9WXE2a53oDk 7. This YouTube video was produced by the Children’s Advocacy Center of Spartanburg. It tells viewers what happens at the CAC from the perspective of a child victim (5:56). https://www.youtube.com/watch?v=7htQLW-R5KI 8. The National Children’s Advocacy Center publishes a series of videos from 5 to 7 minutes each that address different aspects of forensic interviewing with children. https://calio.org/takeaway-tuesday/ Topics include such things as 15 Principles for Forensic Interviewers, Rapport Development and Social Support, Conducting an Effective Narrative Practice, and Subjective Content in Forensic Interviews.

Discussion Topics

1. How might a forensic interviewer keep an open mind when they spend most of their time working with children who were maltreated?

2. Have students interview a child about a recent event (nothing potentially abusive) the child experienced that was witnessed by at least one adult. Direct the students to use good interview techniques to get as much accurate information as possible.

Compare the story the student was told by the child to the adult witness’s account.

It is even better if the event was recorded on video. Students can tape their interviews with the child and allow the class to evaluate their style (most students have phones that are capable of video recording).

3. Have a student volunteer to interview another student (who is acting as a child) about an alleged abusive event in front of the class. Let the other students evaluate the questions posed and the interview style.

4. Invite a forensic interviewer from the local advocacy center to talk with the class about a career as a forensic interviewer. Encourage students to discuss the benefits and drawbacks about this type of work.

5. Due to space limitations, I could not cover all interview protocols in the text. An additional good set of guidelines is provided by APSAC. You can find their 2012 Practice Guidelines: Forensic Interviewing in Cases of Suspected Child Abuse at https://depts.washington.edu/uwhatc/PDF/guidelines/Forensic%20Interviewing% 20in%20Cases%20of%20Suspected%20Child%20Abuse.pdf They cover the purpose of a child forensic interview, interviewer attributes, interview context, interview components, acknowledgements and appendices in 29 pages.

Chapter 12 – The Legal System and Child Maltreatment Test Items 1. Which type of court system is generally more child friendly? a. adversarial b. accusatorial c. inquisitorial d. all are equally child friendly Answer: C 2. According to Saywitz et al. (1990), which of the following is true? a. young children have an amazingly accurate grasp of legal terms b. children’s understanding of all legal terms improves between kindergarten and 6th grade c. developmental improvements were seen only for terms of moderate difficulty d. there were no developmental improvements in the understanding of legal terms between kindergarten and 6th grade Answer: C 3. Juvenile courts were first established in a. 1875 b. 1899 c. 1920 d. 1976 Answer: B 4. If a 14 year old is caught stealing, they are guilty of a. juvenile delinquency b. a status offense c. contributing to the delinquency of a minor d. a dependency violation Answer: A 5. If a 16 year is caught attempting to buy alcohol, they are guilty of a. juvenile delinquency b. a criminal act c. a status offense d. contributing to the delinquency of a minor Answer: C

6. The purpose of cases is to determine whether a child’s needs are met by their current guardians. a. juvenile delinquency b. criminal c. civil d. dependency Answer: D 7. American law employs three standards of proof. Which one is used in dependency hearings in juvenile court? a. Beyond a reasonable doubt b. Clear and convincing c. Preponderance of evidence Answer: B 8. In juvenile court, the hearing is when the court decides if there is enough evidence to detain a child pending a full, 30 day, investigation. a. 72 hour b. jurisdictional c. dispositional d. review Answer: A 9. What happens at the dispositional hearing? a. the court decides if there is enough evidence to hear the case b. the court decides what is to be done with the child c. previous court decisions are reviewed d. permanent plans are made Answer: B 10. Which of the following type of case would not be heard in juvenile court? a. status offense b. juvenile delinquency c. class action d. dependency Answer: C 11. Which of the following types of cases is Juvenile Court NOT responsible for hearing? a. abused children b. neglected children c. children who have committed crimes d. child custody following a divorce Answer: D

12. When researchers interviewed maltreated children who had attended their own hearings, they found that did not know the outcomes of the hearing they attended. a. 0% b. 21% c. 54% d. 76% Answer: C 13. When researchers interviewed maltreated children who had attended their own hearings, they found that did not feel they had been listened to or believed. a. 0% b. 15% c. 37% d. 49% Answer: C 14. Which is not true of families who went through the Family Drug Treatment Courts as compared to those who used the traditional child welfare system? a. Mothers had more positive drug treatment outcomes b. Mothers spent twice as long in drug treatment c. Mothers were significantly more likely to be reunited with their children d. The children achieved permanent placements more quickly Answer: D 15. In Domestic Relations Court parents are thought to be: a. in need of legal assistance, so a lawyer is always appointed b. incompetent as witnesses c. fit and proper adults d. unable to make decisions about their children Answer: C 16. If I fail to follow an order of the Domestic Relations Court, I am a. likely to be sued b. likely to be fined c. likely to be in civil contempt d. likely to be found guilty and sent to criminal court Answer: C 17. What standard of proof is used in criminal court? a. Beyond a reasonable doubt b. Clear and convincing c. Preponderance of evidence Answer: A

18. In criminal court, the defendant first enters a formal plea at the: a. grand jury b. arraignment c. trial d. time of arrest Answer: B 19. The defendant has the most rights in the a. juvenile b. domestic relations c. criminal d. civil Answer: C

court.

20. If you hear a case that is referred to as “The State of SC versus Smith,” you would know this case was being heard in which court? a. Juvenile b. Domestic Relations c. Criminal d. Civil Answer: C 21. According to Cross et al. (2003), out of 100 child abuse claims, alleged perpetrators would likely be incarcerated. a. 5 b. 26 c. 50 d. 78 Answer: B 22. Which type of laws say that some conduct/service/or think causes harm and does not hold up to society’s standard? a. Class action laws b. Status offense laws c. Tort laws Answer: C 23. The laws referred to in #22 are applicable in which court: a. Juvenile b. Domestic Relations c. Criminal d. Civil Answer: D

24. The standard of proof in civil court is a. Beyond a reasonable doubt b. Clear and convincing c. Preponderance of evidence Answer: C 25. cases are those filed by a few people on behalf of a group. a. Criminal b. Delinquency c. Class action d. Dependency Answer: C 26. Which of the following defendants have not been successfully sued for child abuse in civil court? a. Parents b. Insurance companies c. Medical Professionals d. CPS Answer: B

True/False 1.

The U.S. court system is an adversarial system.

Answer: True 2.

All Guardian ad Litems must be attorneys.

Answer: False 3.

Parents who are found guilty of child maltreatment in Juvenile Courts cannot be sent to jail.

Answer: True 4.

Most maltreated children do not attend their own hearings.

Answer: True 5.

Domestic relations court judges have strong enforcement power.

Answer: False 6.

It is easier to get a guilty verdict in civil court than in criminal court.

Answer: True

Matching Who initiates the court proceedings?

1. in domestic relations court?

2. in criminal court?

A. law enforcement and prosecuting attorney B. the involved parents C. child protective services

3. in juvenile court for dependency cases?

Answer: 1. B; 2. A, 3. C Short Answer Questions 1. How does the Child Victim Witness Program (CVWP) differ from the Court Prep Group (CPG)?

Answer: Both programs educate children about court, but they have different approaches. The CPG program works with groups of children, while the CVWP works with each child or family individually. The CPG uses a great deal of art work and role-playing, while the CVWP establishes a support person to assist the child and allows the child to observe a actual court session.

2. What is the purpose of a GAL/CASA? Answer: The purpose of a GAL or CASA is to look out for a child’s rights in court. They provide support to the child and give the child a voice in the legal arena.

3. What are the goals of PREVENT? Answer: PREVENT advocates thorough, research-based evaluations to assess social, emotional, cognitive, and language development. Next, the goal is to use this information to make sure the family receives the resources needed to prevent further negative consequences.

4. What is the primary purpose of the domestic relations court?

Answer: The main function of the domestic relations court is the resolution of legal issues surrounding marriage and the rearing of children (e.g., divorce, child custody, and child support).

5. Compare the standard of proof in a civil court to the standard of proof in a criminal court.

Answer: The standard of proof in civil court is “the preponderance of evidence.”

This is a lower standard of proof than what is used in criminal court, “beyond a reasonable doubt.”

6. List 5 accommodations have been made to assist children who testify in criminal court?

Answer: Any 5 of the following accommodations have been allowed to assist children: Allowing children to testify via close-circuit television Relaxing hearsay rules so adults can prevent more testimony on behalf of children Frequent breaks during testimony Shortening the time to trial Using a child sized table for testimony Having attorneys remain seated while questioning children Shifting the witness chair away from the defendant Not allowing people to enter or leave the court room while a child testified Restrict access to court room while a child testifies Assign a GAL/CASA 7. What is the excited utterance exception to the hearsay rules?

Answer: An exception regarding a statement that is made while under stress about an event, which is admissible in court by a person who heard the original statement 8. Which court do you think is most appropriate for handling child maltreatment cases? Why? Answer: Any court can be correct as long as the student’s reasons demonstrate an understanding of how the court system works.

Video Suggestions 1. This video is 13:41 minutes. It covers the juvenile dependency court for parents.

It was produced by the California Courts. This video was uploaded on May 26, 2015. https://www.courts.ca.gov/1205.htm?rdeLocaleAttr=en 2. This 3:04 minute video reviews dependency court and criminal court following child maltreatment. It is titled, How to Navigate the Legal System after Child Abuse. Narrator is Dr. Karen Kay Imagawa. This video was uploaded on July 3, 2013. https://www.kidsinthehouse.com/all-parents/child-abuse/support/how-navigatelegal-system-after-child-abuse

3. This video is free on You Tube. It is called Kids in Court and it runs 5:52. The video shows a man teaching children about court – who sits where, what they do, and what a child witness would be asked to do. Then, there is a question and answer session. The children ask great questions like, “What if I forget to raise

my hand during the oath? What if I can’t remember the answer? and What if I have to go to the bathroom?” It lets adults know how much basic information children need about court. http://www.youtube.com/watch?v=EswF5p41Sfs 4. This video is free online. It is entitled Through a Child’s Eyes: Innocence in the Court Room. It is 5:18 minute video that shows the courtroom experience from the point of view of a young child (7-year-old Nicole). You see the child follow the bailiff into court, swear in, give testimony, face the defendant, and walk out. It gives an idea of how frightening a full court might appear to a child. https://www.youtube.com/watch?v=CzB9bTbTC38 Discussion Topics 1. Watkins (1984) presents a brief case study of legally mandated therapy for an abusive family. He addresses the issue of resistance seen in response to court ordered treatment. Watkins suggests focusing on family strengths instead of the abuse. Have students discuss the risks of this approach as well as the potential benefits.

Watkins, C. E. (1984). Court ordered treatment in a case of child abuse.

Individual Psychology: Journal of Adlerian Theory, Research & Practice, 40(2), 209–212.

2. Many states have implemented specialized court systems to handle cases of child maltreatment. Have students research whether there are any such programs in your state and, if so, report on those programs to the class.

3. Select a local case that is receiving publicity and has gone to criminal trial.

Follow the case in the media. If there are no local cases, it is easy to research past or current national cases as well.

4. Present cases to the class and ask how each case would be addressed by the different court systems. Try to get the class to come to an agreement on which court system would result in the best outcome for the child. Would a different system be better for a non-offending parent? Which system would be best for the alleged perpetrator?

5. Have the class research a recent class action suit brought on behalf of abused children. What did the courts decide? Was the decision just/fair?

Chapter 13 – The Maltreated Child and Child Protective Services’ Response: What Happens After a Report is Made?

Test Items 1. Which of the following situations does NOT necessarily require an immediate response (i.e., within 2 hours) from CPS? a. The call concerns the physical abuse of a toddler. b. The call regards an 11-year-old who has been left home alone. c. The call is received from the emergency room of a hospital. d. The call concerns a case of sexual abuse in which the perpetrator lives in the home with the victim.

Answer: B 2. Which of the following pieces of information MUST CPS have in order to investigate a report of child maltreatment? a. The name of the alleged victim. b. The name of the alleged perpetrator. c. A specific allegation of child abuse/neglect. d. The address where the child and/or alleged perpetrator live.

Answer: C 3. Which of the following is NOT necessarily considered an “emergency” with respect to CPS response time (i.e., with 2 hours) following a report of child maltreatment? a. The report comes from a hospital emergency room. b. The report is for the physical abuse of a toddler. c. The report is for the sexual abuse of a child in which the alleged perpetrator lives in the child’s home. d. The report is provided by a mandated reporter.

Answer: D 4. Which of the following pieces of Federal legislation requires states to make reasonable efforts to prevent the removal of children from their parents care? a. Adoption Assistance and Child Welfare Act b. Child Abuse Prevention and Treatment Act c. Adam Walsh Child Protection and Safety Act d. Keeping Children and Families Safe Act Answer: A 5. Which of the following pieces of Federal legislation requires a national registry of substantiated cases of child maltreatment to be maintained by the U.S. Department of Health and Human Services? a. Adoption Assistance and Child Welfare Act b. Child Abuse Prevention and Treatment Act c. Adam Walsh Child Protection and Safety Act d. Keeping Children and Families Safe Act Answer: C

6. According to Child Protective Services: A Guide for Caseworkers, which of the following is NOT a basic philosophical tenet of CPS? a. A safe a permanent home is best for children. b. Families who need assistance from CPS are diverse. c. CPS efforts are most likely to succeed when clients actively participate in the process. d. When children are placed in out-of-home care, permanency planning should be developed slowly.

Answer: D 7. The principle that a child’s ideal living environment is one that will be long-lasting and stable is known as a. permanency. b. continuity. c. family preservation. d. family reunification.

Answer: A 8. The principle that a child’s ideal living environment is one that should be disrupted as little as possible is known as a. permanency. b. continuity. c. family preservation. d. family reunification.

Answer: B 9. The federally mandated principle that encourages CPS agencies to maintain biological families whenever possible a. is required by the Child Abuse Prevention and Treatment Act. b. is known as family preservation and reunification. c. is known as permanency. d. is administered by the Office on Child Abuse and Neglect.

Answer: B 10. As part of the intake process, CPS agencies a. determine whether an allegation of child maltreatment is substantiated. b. develop concurrent plans for permanency. c. evaluate family progress. d. determine whether a report of child maltreatment should be accepted for further investigation.

Answer: D 11. Which of the following is NOT part of CPS’ intake process? a. Determining whether a report meets statutory and/or agency guidelines.

b. Conducting a safety assessment to determine the urgency of an allegation and the necessary agency response time. c. Including the alleged victims’ family in the decision-making process. d. Deciding whether to accept a report of child maltreatment for further investigation.

Answer: C 12. The final outcome of a CPS investigation is to a. determine whether an allegation of child maltreatment is substantiated. b. develop a case plan. c. hold meetings to involve the family in the decision-making process. d. determine any services needed to improve the families’ overall well-being.

Answer: A 13. When a report of child maltreatment is unfounded, this means that a. credible evidence indicates that maltreatment has occurred. b. there is a lack of credible evidence to indicate that maltreatment has occurred. c. the alleged victim was not, in fact, maltreated. d. some evidence of maltreatment exists, but not enough to substantiate the case.

Answer: B 14. When a report of child maltreatment is indicated, this means that a. credible evidence indicates that maltreatment has occurred. b. there is a lack of credible evidence to indicate that maltreatment has occurred. c. the alleged victim was not, in fact, maltreated. d. some evidence of maltreatment exists, but not enough to substantiate the case.

Answer: D 15. The process by which an allegation of child maltreatment might lead to referrals for services rather than a CPS investigation is known as a(n) a. differential response system. b. investigative track. c. risk assessment. d. safety assessment.

Answer: A 16. The family group decision-making model a. utilizes family meetings in the case-planning process. b. often increases the willingness of family members to accept services outlined in the case plan. c. increases the support available to families through support networks. d. all of the above Answer: D 17. Which of the following is NOT a primary outcome of case planning? a. Child safety

b. Child permanence c. Out-of-home placement d. Family well-being Answer: C 18. Behaviors that typically pose moderate risk for child maltreatment include a. inappropriate corporal punishment. b. sexual abuse. c. high level of family stress. d. mild neglect (for example, a dirty house in which older children live).

Answer: A 19. Behaviors that rise to the level of high risk for child maltreatment are most likely to require a. parenting education. b. early intervention. c. court-ordered services. d. community support services.

Answer: C 20. Which of the following statements regarding case closure is FALSE? a. Case closure occurs when the case plan has been completed and all outcomes have been achieved. b. Case closure occurs following the termination of parental rights the child has been adopted. c. Case closure may occur when a family receiving voluntary services discontinues involvement with CPS. d. Case closure may occur when a family receiving involuntary services discontinues involvement with CPS. Answer: D True/False 1.

The Adoption Assistance and Child Welfare Act (1980) requires states to make reasonable efforts to prevent the removal of children from their parents.

Answer: True 2.

As part of the family assessment process, a safety plan is typically developed.

Answer: False 3.

A central registry is a statewide database that contains information on all substantiated reports of child maltreatment.

Answer: True 4.

A determination of indicated means that a caseworker has found enough evidence to substantiate that maltreatment has occurred.

Answer: False

5.

The family group decision-making model includes the family in the caseplanning process.

Answer: True Short Answer Questions 1. Discuss the significance of legal terminology and definitions with respect to inconsistencies inherent in CPS decision-making. Provide a specific example to support your answer.

Answer: The ambiguity of legal statutes and terminology, such as “reasonable efforts,” present unique challenges with respect to CPS decision-making. This ambiguity may lead to unclear and/or non-specific operational guidelines for decision makers to follow, which will, in turn, lead to inconsistent decision within and between CPS staff.

2. What is the difference between continuity and permanency with respect to a child’s living environment?

Answer: Both of these terms address a child’s ideal living environment. Permanency focuses on the long lasting nature and stability of a child’s living environment, while continuity focuses on a lack of disruption in the environment.

3. Describe the principle of family preservation and reunification. How has CPS’ adherence to this principle been affected by federal legislation?

Answer: Family preservation and reunification encourages CPS agencies to maintain biological families whenever possible. This principle was especially encouraged through the Adoption Assistance and Child Welfare Act (1990). More recently, however, the Adoption and Safe Families Act (1997) focuses more on the child’s safety and well-being and, therefore, the focus maintaining biological families has lessened.

4. What does it mean when a case is unsubstantiated? Does this mean that maltreatment has not occurred? Explain your answer.

Answer: When an allegation of child maltreatment is unsubstantiated following an investigation this means that there was a lack of credible evidence to indicate that maltreatment has occurred. This does not, however, necessarily mean that the alleged victim was not maltreated, only that there was a lack of evidence to support the allegation.

5. Discuss two advantages to differential response systems with respect to child welfare. What is a potential pitfall to this approach?

Answer: One advantage is that this system is less punitive for families who would likely benefit more from assistance than from investigation. In this situation (for example, a single mother who needs affordable childcare so that she can go to work when her child is sick and cannot attend school), these families are likely to be more receptive to the support and resources made available to them, which will hopefully result in improved family functioning. A second advantage is that it allows CPS agencies to focus their efforts on cases involving more serious maltreatment. These more severe and challenging cases often require increased agency resources, which are more likely to be available if

caseworkers are able to refer the lower risk cases to competent third parties. A potential pitfall to the differential response system is lack of communication between agencies. By incorporating third party contractors, CPS becomes more removed (usually completely) from low to moderate risk cases, which means that family follow through may be lowered and high risk situations may be missed, miscommunicated, etc.

6. What is a potential pitfall to the differential response system?

Answer: A potential pitfall to the differential response system is lack of communication between agencies. By incorporating third party contractors, CPS becomes more removed (usually completely) from low to moderate risk cases, which means that family follow through may be lowered and high risk situations may be missed, miscommunicated, etc.

Additional Case Studies 1. Children’s Bureau. A division of the Administration for Children and Families (http://www.acf.hhs.gov/) that focuses “exclusively on improving the lives of children and families.” This following internet site provides access to a variety of legislative and agency-related child protection topics including National conferences on child abuse & neglect, child welfare outcome data that are reported annually to Congress, child protection training opportunities, and the Commission to Eliminate Child Abuse and Neglect Fatalities (2012). https://www.acf.hhs.gov/cb/focus-areas/child-abuse-neglect 2. Child Welfare Information Gateway. A resource made available through the Administration for Children and Families (http://www.acf.hhs.gov/) that provides extensive and detailed information with respect to child protection and family support. Included are links to resources specifically related to topics such as stateby-state policies, agency responses to reports of child maltreatment, child welfare assessment, family strengthening and preservation services, out-of-home care, and the supervision of child welfare agencies and services. https://www.childwelfare.gov/topics/systemwide/laws-policies/state/ https://www.childwelfare.gov/topics/responding/ https://www.childwelfare.gov/topics/systemwide/assessment/ https://www.childwelfare.gov/topics/supporting/ https://www.childwelfare.gov/topics/outofhome/ https://www.childwelfare.gov/topics/management/ 3. Kempe Center for the Prevention and Treatment of Child Abuse and Neglect. In addition to providing more general information and resources regarding child maltreatment, the Kempe Center provides information specific to Differential Response systems in child protective services and Family group Decision Making. https://medschool.cuanschutz.edu/pediatrics/sections/child-abuse-andneglect-(kempe-center) 4. State of Hawaii Department of Human Services. A slideshow presentation outlining Hawaii’s Differential Response system for child protection.

https://images.slideplayer.com/39/10993788/slides/slide_1.jpg 5. North Carolina Division of Social Services’ Multiple Response System. Here you can find information regarding North Carolina’s efforts to reform their child welfare services beginning with the first report of child maltreatment to permanency planning. https://www.ncdhhs.gov/divisions/social-services/child-welfareservices/multiple-response-system-evaluations-and-reports 6. Liftingtheveil.org. The organization provides access to a report issued by Former Texas Comptroller, Carole Keeton Strayhorn in 2004 (“Forgotten Children”) following an in-depth investigation into reports of fraud and abusive conditions in the state’s foster care system. http://liftingtheveil.org/reports/forgotten-children-carole-keeton-strayhorntexas-comptroller-2004/ 7. Decision-Making in Unsubstantiated Child Protective Services Cases: A synthesis of Recent Research – a report published by the National Clearinghouse on Child Abuse and Neglect Information National Adoption Information Clearinghouse. http://thesociologycenter.com/GeneralBibliography/decisionmaking.pdf 8. Real Cases: Integrating Child Welfare Practice across the Social Work Curriculum –three case studies as part of the “Real Cases Project,” sponsored by the Adelphi University School of Social Work. https://www.adelphi.edu/social-work/wpcontent/uploads/sites/13/2020/06/Real-Cases-Project-Anne-M.-CaseStudy.pdf 9. Designing and Implementing Differential Response Systems in Child Protective Services: A Three State Case Study – prepared by the Department of Urban and Environmental Policy and Planning at Tufts University. https://www.yumpu.com/en/document/view/4031361/designing-andimplementing-differential-response-tufts-university 10. Rethinking the Paradigm for Child Protection – an article published in The Future of Children, Spring 1998, available as a pdf document through the following website. The article includes three case studies of state-based efforts to reform child protection efforts. https://www.semanticscholar.org/paper/Rethinking-the-paradigm-forchild-protection.Waldfogel/8d33fb4902aaa3817aebdc9034c72555945bf837

Video Suggestions 1. The Children’s Bureau: The Right to a Healthy Childhood (2014). This short video provides an historic overview of early parenting-related legislation and activities sponsored by the U.S. Children’s Bureau https://www.youtube.com/watch?v=XdOln7IvNSc&t=327s 2. Foster Care: A System in Crisis (2006). This video includes three ABC News segments (“Calling All Angels,” “A Call to Action,” and “Children on the Brink”) focusing on the challenges faced by families and organizations that provide foster care services to endangered children. May be available through an institutional database such as Films on Demand; alternatively, a DVD may be purchased for $169.95 through the website. https://www.films.com/id/12987/Foster_Care_A_System_in_Crisis.htm 3. Families First. Includes information regarding family preservation programs designed to help families stay together rather than have children enter into foster care. This website includes a 10-minute video clip from a documentary that first aired on PBS in 1991, which may be available through an institutional database such as Films on Demand. https://gailpellettproductions.com/families-first/ 4. Frontline: Failure to Protect. This website includes information related to a twopart special that aired on the PBS program Frontline on January 29, 2003 (“The Taking of Logan Marr”) and February 6, 2003 (“The Caseworker Files”).

Included on this website are video clips from the original broadcasts, interviews with child welfare experts, and factual information regarding U.S. child welfare policy. http://www.pbs.org/wgbh/pages/frontline/shows/fostercare/ 5. The Unlimited Power of Child Protective Services. YouTube video clip featuring a speech delivered by Georgia State Senator Nancy Schaefer following her publication of the report “The Corrupt Business of Child Protective Services.” http://www.youtube.com/watch?v=Ry5eSKyZ98g http://www.youtube.com/watch?v=Y73nFp0Y19c Discussion Topics 1. Have students discuss child protective services’ role in removing children from their parents’ custody. In some states, CPS agencies are empowered with this ability, but in other states only law enforcement has the authority to do so.

Discuss the pros and cons of empowering each of these agencies with this authority.

2. What are culturally responsive services? Engage students in a discussion regarding the importance of culturally responsive services in working with families from diverse backgrounds.

3. Many state child protective service agencies have moved toward (or are in the process of moving toward) alternative/differential response systems (See Case Example 13.3 regarding South Carolina’s Appropriate Response, i.e., Community Based Prevention Services, system). Have students discuss the advantages and disadvantages of adopting these alternative procedures for managing low and moderate risk reports of child maltreatment.

4. Once a case has been closed, CPS is typically no longer involved in that family’s life. They may become involved with a family again if another report is filed, but there is usually no opportunity for any type of post-closure monitoring/support.

Have students discuss the likely rationale for, and the advantages and disadvantages of, this approach.

5. Students often think that CPS either does not do enough to protect children in some cases or, alternatively, intervenes too quickly/drastically in others. What students may not realize is that CPS workers are bound by the law, they may want to take a particular course of action with a family (e.g., remove a child from the home, return a child to the home, etc.), but are unable to do so because they must act in accordance with the law as well. Have students discuss specific case scenarios (many examples can be found throughout the textbook) within the context of what a CPS worker may have wanted, but been unable, to do given the limits placed upon them by our legal system.

Chapter 14 – Preventing Child Maltreatment Test Items 1. An advantage of home visitation programs is a. they are generally available to all parents. b. they specifically target (and decrease the likelihood of) child physical abuse and neglect. c. they often provide additional support and resources to at-risk parents. d. they are fairly easy to implement.

Answer: C 2. An advantage of public service announcements is a. they are available to a large target audience. b. they specifically target (and decrease the likelihood of) child physical abuse and neglect. a. they often provide additional support and resources to at-risk parents. c. they are fairly easy to implement.

Answer: A 3. Which of the following prevention programs targets the potential victim of abuse, rather than the potential perpetrator? a. Child sexual abuse programs b. Group/center-based programs c. Public service announcements d. Home visitation programs Answer: A 4. Which of the following prevention programs targets parents who are considered at-risk for child maltreatment? a. Child sexual abuse programs b. Primary prevention programs c. Public service announcements d. Home visitation programs Answer: D 5. Which of the following prevention programs is universally available to the general public? a. Child sexual abuse programs b. Group/center-based programs c. Public service announcements d. Home visitation programs Answer: C 6. Which of the following prevention programs provides parents with the opportunity to share their experiences with, and provide support to, other parents? a. Child sexual abuse programs

b. Group/center-based programs c. Public service announcements d. Home visitation programs Answer: B 7. Which of the following programs focuses on the prevention of vehicle-related heatstroke fatalities in children? a. The Detroit Family Project b. Where’s the baby? Look before you lock c. Don’t Shake the Baby d. The Period of PURPLE Crying Answer: B 8. Which of the following programs focuses on the prevention of Shaken Baby Syndrome? a. The Detroit Family Project b. Don’t Shake the Baby c. The Period of PURPLE Crying d. B and C Answer: D 9. Which of the following prevention programs is generally considered the “goldstandard” for home visitation? a. Nurse-Family Partnership b. Family Connections Program c. Hawaii’s Healthy Start Program d. Healthy Families America Answer: A 10. Which of the following programs specifically targets the prevention of child neglect? a. Nurse-Family Partnership b. Family Connections Program c. Hawaii’s Healthy Start Program d. Healthy Families America Answer: B 11. A family’s participation in a primary prevention program is usually a. mandated by a child protection agency. b. required only if the family possesses at least 2 risk factors for child maltreatment. c. required only in sexual abuse cases. d. completely voluntary.

Answer: D

12. For all practical purposes, this method of prevention is really a form of intervention. a. Primary b. Secondary c. Tertiary d. None of the above Answer: C 13. Given the interpretation of child maltreatment as a public health issue, this type of terminology is often used describe prevention efforts. a. Epidemiological b. Empirical c. Intrafamilial d. Extrafamilial Answer: A 14. The reduction in the likelihood of an occurrence is called a. precursor. b. prevention. c. attrition. d. recidivism.

Answer: B 15. This method of prevention targets the general population to reduce the incidence of all new cases of a problem. a. Primary b. Secondary c. Tertiary d. None of the above Answer: A 16. This method of prevention targets a specific group of individuals to reduce the incidence of new cases of a problem among those determined to be at some identified risk. a. Primary b. Secondary c. Tertiary d. None of the above Answer: B 17. This method of prevention is intended to minimize the negative effects of an already existing problem. a. Primary b. Secondary c. Tertiary d. None of the above Answer: C

18. This term borrowed from medical science to refer to maladaptive behavior patterns as lifelong illnesses. a. Prevention b. Etiology c. Epidemiology d. Disease model Answer: D 19. Which of the following is considered a proxy measure for the true prevalence of child maltreatment? a. Reports to child protection agencies b. Risk factors for child maltreatment c. The use of physical discipline d. All of the above Answer: D 20. The research on child sexual abuse prevention programs generally shows that concerns regarding the suitability of these programs for children a. are warranted, given the many negative side effects that result from program participation. b. are warranted, given that these programs tend to have few (if any) positive effects. c. are unwarranted, given the few negative side effects that result from program participation. d. vary depending on whether the program includes parental involvement.

Answer: C True/False 1.

A family’s participation in a primary prevention program is usually mandated by a child protection agency.

Answer: False 2.

The majority of prevention programs for physical abuse and neglect focus on service delivery to parents.

Answer: True 3.

Sexual abuse prevention programs typically focus on helping children protect themselves from becoming victims.

Answer: True 4.

The Period of Purple Crying targets the prevention of Shaken Baby Syndrome.

Answer: True 5.

Primary prevention programs target those at risk of maltreatment.

Answer: False 6.

It is easier to get a guilty verdict in civil court than in criminal court.

Answer: True Short Answer Questions 1. What is the difference between primary and secondary prevention? In your answer, be sure to provide a specific example of each.

Answer: Primary prevention targets the general population to reduce the incidence of all new cases of a problem. An example includes public service announcements. Whereas, secondary prevention targets a specific group of individuals to reduce the incidence of new cases of a problems among those determined to be at some identified risk. An example includes a home visitation program.

2. Research on the effectiveness of prevention programs for child maltreatment often measures proxy variables. What does this mean and why do we take this approach? In your answer, be sure to provide a specific example of one such proxy variable.

Answer: Proxy variables are variables that are used instead of the actual variable of interest because it cannot be measured or is difficult to measure. We take this approach in studying the effectiveness of child maltreatment prevention programs because, typically, our variable of interest is the prevalence of child abuse and/or neglect. This prevalence rate is difficult, if not impossible, to determine. Instead, we measure variables that are related to this variable of interest. For example, we might measure the use of physical discipline, which is a risk factor for physical abuse and, therefore, a proxy measure for child maltreatment.

3. Describe and provide 2 advantages/benefits for public service announcements as a type of child abuse prevention program.

Answer: Public service announcements are media campaigns, and are a form of primary prevention. They include television and radio programming commercials, billboards, advertisements in newspapers and magazines, internet websites, and pamphlets or brochures. The advantages of public service announcements are that they can reach a large target audience and they can be influential in educating the general public about a problem for which there has previously been limited awareness.

4. Describe and provide 2 advantages/benefits for home visitation programs as a type of child abuse prevention program.

Answer: Home visitation programs are a comprehensive form of secondary prevention in which professionals (typically nurses) or paraprofessionals (people who have received some specialized training but are not professionally licensed) go to the homes of those identified at-risk for child maltreatment and provide a variety of educational, case management, therapeutic, and referral services. The advantages of these programs are that often provide much needed services to those who likely do not have the resources to otherwise obtain these services. They are also more specific in their focus than primary

prevention programs and, therefore, can provide services to those who are most likely to benefit from their use.

5. Name and describe the three categories of prevention programs. From what field of study has this categorization system been borrowed? Provide one example in which applying this terminology to the prevention of child maltreatment has proven challenging and/or confusing.

Answer: The three categories of prevention programs are primary, secondary, and tertiary. This categorization system had been borrowed from the field of public health and, therefore, utilizes epidemiological terminology. Applying this terminology to the prevention of child maltreatment has proven confusing with respect to tertiary prevention, which is often considered synonymous with intervention.

6. Most child maltreatment prevention programs focus on potential perpetrators (i.e., adults) as the target audience; however, most sexual abuse prevention programs target the potential victims (i.e., children). What is the rationale for targeting the potential victims, instead of the potential perpetrators, for these programs?

Answer: The rationale for targeting the potential victims (i.e., children) in sexual abuse prevention programs is that we can limit the occurrence (and/or minimize the effects) of sexual abuse by educating children regarding specific sexual abuse-related information (e.g., “stranger danger,” “good touch/bad touch,” etc.), providing them with techniques for protecting themselves from perpetrators (e.g., role plays), and providing them with opportunities to disclose past or current abuse to an adult. Since it is difficult to predict potential perpetrators (and difficult to effectively prevent their likelihood for perpetration), targeting potential victims has become the more standard operating procedure.

Additional Case Studies 1. The Centers for Disease Control. This organization provides information regarding basic child maltreatment facts and prevention efforts currently supported by the CDC. http://www.cdc.gov/violenceprevention/childmaltreatment/ 2. Child Welfare Information Gateway. A resource made available through the Administration for Children and Families (http://www.acf.hhs.gov/) that provides information on the prevention of child maltreatment. Included is information regarding strengthening families, public awareness, program overviews, and evidence-based practice. https://www.childwelfare.gov/topics/preventing/ 3. Prevent Child Abuse America. A national organization that builds awareness and provides education to all those involved in preventing the maltreatment of children. Includes information regarding Healthy Families America. https://preventchildabuse.org/

4. Nurse-Family Partnership. A nationwide nurse home visitation program aimed at improving the health and well-being of first-time mothers and their young children. http://www.nursefamilypartnership.org/ 5. Durham Connects. A prevention program in Durham County, North Carolina that is available to all new parents residing (and giving birth) in that county. Services include a postnatal home visit with a registered nurse for all families. https://www.ccfhnc.org/programs/family-connects-durham/ 6. Darkness to Light. This organization aims to educate adults about the steps they can take to prevent child sexual abuse. http://www.darkness2light.org/ 7. Triple P – Positive Parenting Program. An online program that aims to provide evidence-based parenting strategies to all parents. https://www.triplep.net/glo-en/home/ 8. Period of PURPLE Crying. A program to prevent Shaken Baby Syndrome. http://www.purplecrying.info/ 9. The Child Abuse Prevention Center – a California-based organization. http://www.thecapcenter.org/ Video Suggestions 1. Several YouTube videos depicting public service announcements for the primary prevention of child maltreatment, many more are available. http://www.youtube.com/watch?v=cFzxOX_bRFk http://www.youtube.com/watch?v=-sFRt-dotN0 http://www.youtube.com/watch?v=d3d1Dw6uV4s http://www.youtube.com/watch?v=UegahvDz3nM http://www.youtube.com/watch?v=LpZIkUJ43-M 2. Durham Connects. This website includes a video clip describing a free prevention program in Durham County, North Carolina that is available to all new parents residing (and giving birth) in that county. http://www.youtube.com/watch?v=Qjttbdfq50w 3. Period of PURPLE Crying. These YouTube videos include information about the Period of Purple Crying, a program to prevent Shaken Baby Syndrome. https://www.youtube.com/watch?v=9Gz8l02pwTU https://www.youtube.com/watch?v=X0SXJQ0a-QY 4. Fundación ANAR – A Spanish organization (Aid to Children and Adolescents at Risk www.anar.org) created a bus-stop advertisement that features the organization’s hotline number for children to report child abuse. The

advertisement employs lenticular photography, which allows the advertisement to be visible to people under a certain height (i.e., children). A description of the advertisement was reported by the Huffington Post http://www.huffingtonpost.com/2013/05/06/child-abusead_n_3223311.html?ir=Technology) and a video demonstration of the advertisement can be found at the following website. https://www.youtube.com/watch?v=Z2syiUWroy4 5. A YouTube video about the California-based Child Abuse Prevention Center. http://www.youtube.com/watch?v=h9yf2LSeXQI 6. A collection of videos made available through the Child Abuse Prevention Fund of the Children’s Hospital of Wisconsin. http://www.youtube.com/playlist?list=PL1341BF4EDA5EDE9C 7. End it Now: Understanding and Preventing Child Abuse – a child abuse prevention video produced by Loma Linda University Health. http://www.youtube.com/watch?v=H-6elfGAWLY