Child Abuse Identification and Reporting: The Pennsylvania Requirement _____________________________
Nothing under Pennsylvania law requires a person who has reasonable cause to suspect a child is a victim of child abuse to identify the person responsible for the child abuse in order to make a report of suspected child abuse. FORMS OF CHILD ABUSE There are several acts that may be considered abusive, and knowledge of what constitutes abuse is vital for healthcare providers and other mandated reporters. In this section, specific behaviors that fall under the category of abuse and neglect will be reviewed. Bodily Injury Bodily injury can range from minor bruises and lacerations to severe neurologic trauma and death. Bodily injury is one of the most easily identifiable forms of abuse and the type most commonly seen by healthcare professionals [34]. Definitions (23 Pa.C.S. § 6303) The following words and phrases, when used in the PA CPSL, shall have the meanings given to them in this section unless the context clearly indicates otherwise: • Bodily injury: Impairment of physical condition or substantial pain – Impairment: If, due to the injury, the child’s ability to function is reduced temporarily or permanently in any way – Substantial pain: If the child experiences what a reasonable person believes to be substantial pain Indicators of bodily injury include: • Fear of going home • Fear of parent or caregiver
Fractures that result from abuse might be found on the child’s skull, ribs, nose, or any facial structure. These may be multiple or spiral fractures at various stages of healing. When examining patients, note bruises on the abdominal wall, any intestinal perforation, ruptured liver or spleen, and blood vessel, kidney, bladder, or pancreatic injury, especially if accounts for the cause do not make sense. Look for signs of abrasions on the child’s wrists, ankles, neck, or torso. Lacerations might also appear on the child’s lips, ears, eyes, mouth, or genitalia. If violent shaking or trauma occurred, the child might experience a subdural hematoma [9; 34].
According to the American College of Radiology, fractures highly suggestive of physical abuse include rib fractures, classic metaphyseal lesions, those unsuspected or inconsistent with the history or age of the child, multiple fractures involving more
than one skeletal area, and fractures of differing ages. (https://acsearch.acr.org/docs/69443/Narrative. Last accessed December 9, 2024.) Level of Evidence : Expert Opinion/Consensus Statement
Sexual Abuse/Exploitation Definitions (23 Pa.C.S. § 6303) Sexual abuse or exploitation includes any of the following [45]: • The employment, use, persuasion, inducement, enticement, or coercion of a child to engage in or assist another individual to engage in sexually explicit conduct, which includes, but is not limited to, the fol- lowing: – Looking at the sexual or other intimate parts of a child or another individual for the purpose of arousing or gratifying sexual desire in any indi- vidual – Participating in sexually explicit conversation either in person, by telephone, by computer, or by a computer-aided device for the purpose of sexual stimulation or gratification of any individual – Actual or simulated sexual activity or nudity for the purpose of sexual stimulation or gratification of any individual – Actual or simulated sexual activity for the purpose of producing visual depiction, including photo- graphing, videotaping, computer depicting, or filming
• Extreme apprehensiveness/vigilance • Pronounced aggression or passivity • Flinches easily or avoids being touched • Play includes abusive talk or behavior • Unexplained injuries
• Unbelievable or inconsistent explanations of injuries • Injuries inconsistent with a child’s age/developmental level • Unable to recall how injuries occurred or account of injuries is inconsistent with the nature of the injuries • Multiple bruises in various stages of healing • Bruises located on face, ears, neck, buttocks, back, chest, thighs, back of legs, and genitalia • Bruises that resemble objects such as a hand, fist, belt buckle, or rope • Burns
7
MDPA2326
Powered by FlippingBook