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Child Abuse Red Flags
According to Child and Family Services of New Hampshire. 
• Physical signs such as broken bones, bruises on the arms, chest, or face and bruises that are unexplained or suspicious
• Changes in personal appearance, such as poor hygiene 
• Changes in behavior, such as cowering when approached, or acting withdrawn
• Acting out sexual abuse with themselves, dolls, or peers
• Regressive behavior, such as reverting back to bedwetting or thumb sucking 
• Fears about or refusal of doing things or going places that they enjoyed in past
• Sudden mood changes such as withdrawal, becoming uncooperative
• Lack of attentiveness in school and worsening academic performance
 Visit dhhs.state.nh.us/dcyf or call 800-894-5533.
 




Keeping kids safe
State agencies talk about child abuse prevention efforts

04/18/13



4/18/2013 -Child abuse is never a pleasant discussion, says Maggie Bishop, director of the state Division of Children, Youth and Families, but the consensus seems to be that while challenges and obstacles remain, progress is being made and perceptions are changing.

 
There is a longstanding view that DCYF is the agency that takes kids away from parents, she said, but that is the absolute last resort. Six or seven years ago, Bishop said there were probably 1,400 children in out-of-home placements because of abuse and neglect. Today, there are less than 700. That’s because officials have beefed up efforts to keep kids safe in the home. 
 
“I would love the day, and I think we’re closer than ever before, when DCYF is part of the community, that it’s not the community and DCYF,” Bishop said. “... We’re not the agency that just scoops in and takes people’s kids. We’re the agency that wants to help you keep your kids safe.”
 
Even in cases where DCYF does remove a child from a home, the goal is to get that child back into the home as soon as possible. 
 
“If a child can go home, it should happen as quickly as possible,” Bishop said. “The practice has shifted to make sure we focus on reunification first. The faster it can happen, the better.”
 
That’s evident in how much time children spend in out-of-home placements, which today is between one and two years, compared to years ago, when it was much longer. Years ago, it was more likely the child would remain in placement through childhood, Bishop said. 
 
“It’s almost nonexistent for that to happen now,” said Jack Lightfoot, a former advocacy director for Child and Family Services, an independent, nonprofit agency working to advance children’s well-being, including child abuse prevention, treatment and intervention services. 
 
“Children should be raised by their parents and their family, not the state,” Bishop said. 
 
She said research has shown outcomes for kids who grow up in the system are not as good. 
 
Perceptions regarding DCYF may be changing, but dealing with child abuse isn’t getting any easier. Officials have seen abuse cases become more complex. Families struggling with child abuse and neglect, typically are also dealing with other issues, such as substance abuse, domestic violence or mental health issues. That’s the reality in New Hampshire and nationally, Bishop said. 
 
Even without other factors, abuse is never simplistic. Abuse takes many forms. Physical abuse, which can result in bruising and broken bones, is likely the easiest kind of abuse to identify. Sexual abuse can be more difficult for agencies to deal with, because for DCYF to get involved, officials must show that parents were neglectful of the child, said Linda Nagle, a trauma specialist and program director with Child and Family Services. Emotional abuse is probably the most difficult to deal with, since it doesn’t result in any type of physical injury, Nagle said. 
 
“Sticks and stones will break your bones but words will never hurt you, but we know that’s not true,” Nagle said. “Certainly, they have long lasting effects on children.”
 
Neglect can take a variety of forms. Perhaps children are left in a home that is in deplorable conditions, which creates a high risk situation for kids. It could be educational neglect, if parents don’t make any effort to get kids to school. It could be a lack of supervision, Nagle said. 
 
Nagle said it is more difficult to substantiate cases. It always was difficult. For example, sometimes when kids disclose things, they recant later or perhaps they won’t talk at all. 
 
Make the call
 
Anyone who witnesses child abuse or who suspects child abuse is legally required to report it. As such, the Division gets calls from all over the state. Those calls are the only way DCYF gets involved, Bishop said. Once a call comes in to DCYF central intake, staff members screen calls to determine urgency and to determine whether or not staff should respond. 
 
People are more educated about child abuse issues today and thus are more likely to pick up the phone to report something they find suspicious. Even if the report doesn’t ultimately warrant an investigation, that doesn’t mean the person shouldn’t have called. 
 
“If you don’t speak up for the child, then who will? Because the child doesn’t have a voice,” Nagle said. 
 
That’s how families fly under the radar. In the most extreme abuse cases that receive media attention, Lightfoot said it’s typical state officials knew nothing about the situation in advance.
 
“It takes a village,” Bishop said. “Your concerns could result in an investigation or maybe it’s not abuse and neglect. That’s OK. You called and checked. We’d rather screen your call out rather than have you not call and then find out a child got hurt.”
 
There can be a gray area for people. 
 
“There’s situations where somebody sees something is happening but maybe they don’t think it’s bad enough or they don’t know what to do,” Lightfoot said. 
 
Other times, people don’t report abuse due to fear of retaliation from the perpetrator. 
 
Calls to central intake have increased gradually through the years. The percentage of calls that are substantiated as abuse or neglect has remained fairly steady at about 8 percent. In 2008, central intake received 19,830 calls and substantiated 10.3 percent of calls. In 2011, the state received 20,508 calls and substantiated 7.3 percent of calls. The number of open placements has decreased as well. 
 
Making a difference
 
Once DCYF gets access to parents and the home, the Division has 60 days to work with the family to determine whether abuse or neglect is happening. Typically, caseworkers know much sooner than that. Workers perform an initial safety assessment. If the situation isn’t safe for the child, workers will try to figure out a short-term solution. For example, if one parent is a problem, perhaps the parent can leave, while the child stays with the other parent, Bishop said. 
 
In many cases, children aren’t yet being abused or neglected, but there are risk factors. In those cases, DCYF works with families to get on the right track to make sure abuse and neglect doesn’t start. 
 
“Maybe it’s a single mom struggling to get childcare,” Bishop said. “So we help get the child into childcare and then the issue is resolved.”
 
In many of those instances, the issues are resolved without having to open a case. The only problem is that sometimes it appears the Division has low substantiation rates. But Bishop said in the vast majority of reports, something is going on.
 
“Our assessment allows us to mitigate the risk and then it never becomes abuse and neglect,” Bishop said. 
 
Child and Family Services works with 50 to 100 families each year. Any family that Child and Family Services works with is also working with DCYF, Lightfoot said. 
 
“These families are struggling in some way,” Lightfoot said. “Parents want to do the right thing but they don’t know how. We can help them do it.”
 
Lightfoot said he’s seen improvement in how officials investigate abuse and neglect, as well as how officials carry out treatment plans for children and families. Federal law requires agencies to make a decision on what the long-term solution will be within 12 months of a case opening. 
 
“So you can’t just come into foster care and decide, ‘OK, let’s think about it,” Lightfoot said. “Ultimately, within a year, you need to know what you’re going to do with the child.”
 
Getting access to families
 
It’s no easier today for DCYF caseworkers to talk to parents and to get inside their homes to assess the situation. A law passed several years ago requires staff members to immediately inform parents that they do not have to talk to them. Then, parents must sign a form indicating they know they don’t have to talk to DCYF staff. 
 
“The law has a lot of supporters, that you can’t just come into somebody’s home because somebody has a concern about what you’re doing,” Bishop said. “Has it left some children at risk? Absolutely.”
 
Parents have never had to let DCYF staff into their homes or talk to them, but previously, caseworkers didn’t need to disclose that right away, Bishop said. 
 
“They used to be able to engage in a problem solving approach … rather than setting if off as an adversarial relationship,” Lightfoot said. 
 
Whether a parent lets caseworkers in or not, the Division still has the responsibility to respond. That can be challenging. Bishop said her workers have found creative ways to work around parents, such as calling schools or pediatricians to assess the situation. If parents refuse to let DCYF in, caseworkers would need to get a court order to get inside. To obtain a court order, the workers would need sufficient evidence. 





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