Know

我们都希望让孩子安全。为此，我们必须能够识别孩子何时受到伤害的方式。寻找儿童福利信息网关事实表上的以下迹象及儿童虐待和Neglect（美国卫生和人类服务部）。

孩子：

• 显示似乎似乎像回归的行为或变化的突然变化（失去技能，他们曾经有过，哭泣等）
• 没有收到父母注意力的身体或医学问题的帮助
• Is always watchful, as though preparing for something bad to happen
• Lacks adult supervision
• Is overly compliant, passive, or withdrawn (doesn’t respond to situations that seem to warrant a response)
• Has little reaction to parents at pick-up or drop-off

The parent:

• Shows little concern for the child
• 否认存在 - 或责备孩子在节目中或家中的孩子的问题
• Asks caregivers to use harsh physical discipline if the child misbehaves
• 将孩子视为完全糟糕，毫无价值或繁重
• Demands a level of physical or cognitive performance the child cannot achieve
• Looks primarily to the child for care, attention, and satisfaction of emotional needs

The parent and child:

• Rarely touch or look at each other
• Do not respond to each other after a separation (i.e., at pick-up time)

It’s not always easy to recognize child abuse and neglect. Remember that any one of these signs by itself does not necessarily mean a child has been abused or neglected. Often a pattern or combination of behaviors may lead to the suspicion that a child is experiencing abuse or neglect. Watch this video to learn about recognizing abuse and neglect.

Asking Questions and Opening the Lines of Communication

所有幼儿偶尔会受到伤害：颠簸，瘀伤和刮擦可能是健康探索的迹象。有时候，更严重的事故也会发生：孩子在自己或孩子们参与车祸中拿出一杯热茶。有时，医疗状况会导致模仿滥用的症状。例如，一些皮肤状况可以留下看起来像瘀伤或疤痕的标记。最有效地保护婴儿和幼儿免受儿童虐待和忽视，我们必须能够区分事故和滥用。对话是一个强大的工具。每当您注意到孩子的伤害或症状时，都会完成事件或事故报告并询问受伤。这是护理的标准部分，并表明您对孩子的幸福感兴趣。记住，你是not investigating伤害。当有人受伤时，你只是在做自然的事情：询问发生了什么以及该人是如何做的。以下是提出问题的一些提示：

• 提出开放式问题。你可能会说，“哎哟。看起来很痛苦。发生了什么？”
• Show concern and empathy: “I bet that was pretty scary for you guys. How did it happen?”
• Make sure it’s an OK time to talk, and be prepared to get help if the family needs it. “Is it OK to ask you about Geri’s bruises? Do you have a minute?”
• 了解是否还有什么您应该了解的伤害。“我很高兴你带她去医生。我们应该做些什么来让她在白天舒适吗？或者有什么她不应该做的？“

在大多数情况下，家庭成员将为您提供清晰准确的事件。对于较旧的幼儿，您也可以询问孩子发生的事情。您可能怀疑虐待儿童或忽视：

• 孩子的答案和成年人的答案与两种不同的成年人不匹配，或者如果两个不同的成年人对如何发生伤害的情况发生冲突。例如，孩子在她的脸上划伤。在下车时，她的父亲说她从生日聚会的孩子那里得到了他们。在拾取时，她的妈妈说她从家里猫那里得到了他们。
• The story does not seem consistent with the child’s developmental level. For example, you might suspect abuse if a parent says a 4-month-old climbed out of a crib and got hurt.
• 故事与伤害不一致。例如，孩子手上的烧伤痕迹看起来几乎像手套 - 他的手显然是在热的东西中淹没。他的母亲说孩子不小心抓住了炉子。当孩子拉开时，意外烧伤伤害通常会显示某种泼溅模式。

Shaken Baby Syndrome

Shaken Baby综合征是一种头部创伤和脑损伤的形式。它可能是由于猛烈地摇晃，下降或抛出婴儿造成的。大多数摇动婴儿综合征的受害者在1岁以下，受害者的平均年龄在3到8个月之间。当婴儿被动摇时，他们的颈部肌肉不足以控制他们的头。这导致大脑在头骨内来回移动。结果是出血和瘀伤的大脑。当摇动以突然的冲击结束时，效果甚至更差，因为孩子撞入婴儿床或靠墙时。

寻找摇动婴儿综合征的以下症状。请记住，单独的任何一个标志都不是滥用的明确证据。寻找以下内容：

• 改变意识
• 无法聚焦眼睛或轨道运动
• an inability to lift the head
• decreased alertness
• 呼吸困难
• extreme irritability
• lack of smiling or vocalizing
• lethargy
• pale or bluish skin
• poor feeding
• problems sucking or swallowing
• rigidity
• seizures
• 瞳孔大小不等
• vomiting

Your Training and Curriculum Specialist or manager can be valuable resources as you learn about the signs of child abuse and neglect. They are your first line of support. Go to them whenever you have questions or concerns.

Your Family Advocacy Program can provide training and technical support around recognizing child abuse and neglect. Talk to your T&Cs, manager, and Family Advocacy Program representative about any questions or concerns you have.

The Family Advocacy Program will provide more installation- and Service-specific training on local issues, protocols, and resources. You will also receive additional training from your T&Cs throughout your career. The Virtual Lab School course is just the beginning of your professional learning around reporting and preventing child abuse and neglect.

You can find a quick summary of FAP roles and responsibilities as an attachment at the end of the Learn section.

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The following are signs often associated with particular types of child abuse and neglect. It is important to note, however, that these types of abuse are more typically found in combination than alone. A physically abused child, for example, is often emotionally abused as well, and a sexually abused child also may be neglected. Remember, there are two kinds of abuse to remain aware of: familial and institutional. The signs and behavioral indicators you see in children may be similar for each.

Recognizing Child Abuse and Neglect in Child Development Centers

照顾孩子可能是一个压力的工作。在不适当的护理措施和虐待儿童之间可以有一条罚款。有疑问，与你谈谈PUBLICT&Cs or manager.米尔T&Cs, manager, or FAP.在预防中心设置中虐待儿童的课程中，您将更多地了解积极指导和纪律策略。有时，纪律措施将线路交给虐待甚至虐待。您将在下一课程中了解更多信息。本课程侧重于儿童开发中心虐待或忽视的清晰示例。如果您看到任何这些迹象或行为的模式，您可能怀疑您的环境中的虐待或忽视：

Common Conditions Mistaken for Abuse

There are several medical conditions that often bring about symptoms that could be mistaken for abuse. It is important to be aware of these conditions, but remember you are not responsible for making medical diagnoses. If you have questions, ask the family or a community resource for support.

• Mongolian spots: These gray spots are present at birth and often look like bruises. They are usually found on the buttocks or lower back, but they can be found anywhere. They fade slowly over time.
• Blood or bleeding disorders: Some genetic conditions can cause severe bruising.
• 骨缺陷或疾病：一些骨病导致骨骼容易地打破。

Cultural Practices Mistaken for Abuse

一些文化有仪式或治疗方法，可能误认为是滥用的迹象。应立即报告所有疑似滥用虐待问题。确定你看到的是文化实践还是虐待事件不是你的工作。您应该提出一份报告，让儿童保护服务或FAP进行确定。本节仅适用于有关海关的一些基本信息，可以误以为虐待儿童。两个常见的例子正在压制和拔罐。

在压印，胸部，背部和肩部被用含药软膏擦拭。然后将温热的铜硬币从背部沿后的肩部摩擦。深线从压力和热量出现。这痕迹看起来像长瘀伤，通常持续数天。

Cupping is a home-remedy used to relieve pain in the legs, back, chest, abdomen, or head. A small glass cup is held upside down and a candle is lit inside it. The cup is quickly placed on the skin and a vacuum effect draws the skin up. A circular mark is left on the skin for several days. Often there is a series of cup marks along the affected area. Michael Phelps brought the practice to the forefront during the 2016 Olympics.

There are many other cultural practices that might be considered child abuse by state law. If you are unsure whether a mark is a sign of child abuse, it is always best to make a report. The appropriate authorities will make the determination.

Do

• Get to know all of the children in your care and their families. You cannot recognize a problem if you don’t know what is typical for the child. Learn children’s patterns, temperaments, preferences, and abilities. Talk to families every day.
• 了解孩子的发展。孩子行为的一些变化可能是惊人的 - 但完全典型的。例如，幼儿在他们的腿上或头上都没有瘀伤并不罕见。堕落是学习行走和跑步的一部分！yabo电子游艺幼儿可能害怕某些成年人，作为典型的“陌生人焦虑”的一部分。了解这些发展阶段可以帮助您识别孩子的行为超出通常预期的时间。
• Attend trainings offered by your installation’s Family Advocacy Program on child abuse identification and reporting.
• Develop respectful communication skills. If you have a concern, ask about it. Ask open-ended questions that focus on the child’s well-being. “Is it OK if I ask you about Jordan’s bruises?” or “I’ve noticed that Tasha hasn’t seemed like herself lately. Is everything OK?” If something doesn’t seem right, gather as much information as you can.
• Keep careful records. Your daily health screening can be an important tool for identifying child abuse and neglect. Look for signs or behavioral indicators and write down what you see or hear. Write down adults’ explanations for injuries and children’s explanations (if applicable). If a pattern emerges, you will have ample evidence for making your report.
• 了解您服务的孩子的文化。一些文化有仪式或治疗方法，可能误认为是滥用的迹象。如果您需要帮助，请向您的教练或经理询问信息。如有疑问，提出报告。儿童防护服务米尔or the Family Advocacy Programwill decide whether abuse has occurred.
• Learn reporting procedures for your state米尔or installation。You will learn more about this in the next lesson.