SUMMARY
It is the position of the National Association of School Nurses that school nurses must be familiar with and comply with applicable laws that identify them as mandated reporters of child abuse and neglect and that school nurses must be actively involved in establishing safe environments for all children. It is within the scope and standards of practice of school nurses to:
Provide personal body safety education to students,
Educate and support staff regarding the signs and symptoms of child abuse and/or neglect and on mandated reporting laws,
Support victims of child abuse and/or neglect, and
Link victims and families to community resources.
HISTORY
Many children are at risk for, or are victims of, variable degrees of child maltreatment. Maltreatment of children can be grouped into subtypes including physical abuse, child neglect, sexual abuse, and emotional abuse (Joint Center for Poverty Research, n.d.). A fifth subtype of abuse is that of exploitation (World Health Organization, 2002). In addition, many states have passed legislation to address the serious concern of children’s exposure to methamphetamine during its manufacture and use (Child Welfare, 2004). Some states have amended the definition of child abuse to include manufacturing dangerous drugs in the presence of children. Others have added criminal offenses or enhanced the penalties associated with such exposure.
Abuse or neglect of a child involves actions that result in significant harm to a child’s well-being or inactions that result in a child being deprived of the basic need for nurturance, support, and safety (Hootman, 1996). The federal Child Abuse Prevention and Treatment Act (CAPTA) defines the minimum standards of child maltreatment. The actual prevalence of child abuse and neglect is difficult to determine because many cases of abuse or neglect are not reported (Shaw, 2002). child protection agencies reported 2.9 million referrals during 2003 involving 5.5 million children with approximately two-thirds of these being investigated (National Clearing House on Child Abuse and Neglect, 2005).
Each of the fifty states has enacted laws defining child maltreatment and has determined criteria for outside intervention when necessary. Data from Child Maltreatment 2003 revealed that more than 60% of substantiated reported cases were for child neglect. Almost 19% were for physical abuse, 5% emotional abuse, and 17 % were "other types" of abuse dependant upon state law (USDHHS, 2005).
DESCRIPTION OF ISSUE
School personnel and volunteers have an opportunity to interact with children on a daily basis over an extended period of time. Regular interaction allows for observation of unusual behavior(s) and for the opportunity to develop trusting relationships that may lead to direct or indirect disclosures of child maltreatment. All employees and volunteers within the school setting must be knowledgeable of, and strictly adhere to, state mandated reporting laws as well as district policy for child abuse and neglect. Federal law mandates that teachers and administrators in schools must report child abuse. In all states, federal law mandates that teachers and administrators report child abuse and neglect. In most states, nurses and other school personnel are also mandated reporters. In order to ensure the privacy and protection of children and their families, many state laws prohibit dissemination of confidential information to school employees after the initial interview of a child (Child Abuse Prevention and Treatment Act, 2003).
Community awareness and prevention programs are vital steps in identifying victims and perpetrators of child abuse and/or neglect. Careful and effective risk assessment, intervention, access to care and prevention programs will create a safer society for children and prevent re-victimization (Shaw, 2002).
RATIONALE
Child abuse and neglect is a crime. Victims of child abuse and neglect are adversely affected in many ways, and early intervention is crucial in preventing further victimization and insuring complete psychological recovery. As the primary health care provider in the educational setting, the school nurse is frequently consulted about suspicions of child abuse and/or neglect. It is the professional responsibility of school nurses to keep current on mandated reporting requirements so they can provide leadership and support to staff members, especially when making a report, to assure that the reporting procedure is properly carried out for each and every child, as mandated by law.
References/Resources
Child Abuse Prevention and Treatment Act as amended by Keeping Children and Families Safe Act of 2003, 42 U.S.C. § 5 106(g) (2003). Retrieved January 21, 2006, from http://www.nccanch.acf.hhs.gov.
Child welfare: Innovations in state policy. State Child Welfare Legislation: 2004. (2004, May). Retrieved January 28, 2006, from http://www.ncsl.org/programs/cyf/cwlaws2004.htm.
Hootman, J. (1996). Quality nursing interventions in the school setting: Procedures, models and guidelines. Scarborough, ME: NASN.
Joint Center for Poverty Research. (n.d.). Retrieved January 22, 2006, from http://www.jcpr.org/conferences/chldmltrtmnt.html.
National Clearing House on Child Abuse and Neglect Information. (2005). Retrieved January 29, 2006, from http://www.nccanch.acf.hhs.gov.
Shaw, K. (2002). A summary of the literature on child sexual abuse and exploitation. Retrieved February 20, 2002, from http://www.ispcan.org/Resources/Literature%20Search%20Project.htm.
Swetlow, K. (2003, June). Children at clandestine methamphetamine labs: Helping meth’s youngest victims. Retrieved March 21, 2006, from http://www.ojp.usdoj.gov/ovc/publications/bulletins/children.
U.S. Department of Health and Human Services (DHHS), Administration on Children, Youth, and Families. (2005). Child Maltreatment 2003. Retrieved January 22, 2006, from http://www.acf.hhs.gov/programs/cb/pubs/cm03/cm2003.pdf.
World Health Organization. (2002). Retrieved January 10, 2006, from http://www.who.int/violence_injury_prevention/violence/neglect/en/print.html.
Adopted: June 1974
Revised: June 1982, 1985, 1996, 2002
Revised: June 2006