Ask Us Anything About... Child Abuse
Prevention. I'm Scott Gilbert. You may
have noticed 394 pinwheels out in front
of Penn State Children's Hospital this
month. That's because, April's National
Child Abuse Prevention Month and each
pinwheel represents one child who was
helped in 2016 by the Penn State Center
for the Protection of Children. The
director of that Center is
Dr. Lori Frasier and she's with me right now and
she's joining us for this edition of Ask
Us Anything About. Dr. Frasier, thanks for
your time. Thank you for having me, Scott.
Well one of the reasons we're talking
today is to give people advice on what
to do if they suspect abuse may be
happening to a child that they see or
child that they know. What about the
neighbor or the sports coach or someone
who suspects something. What are some
steps that that person should take? Well
we all have a moral and ethical
obligation to report child abuse when
it's happening. If your professional who's
licensed even if you're not at your job
you have a mandatory obligation to
report child abuse. So, if you have a
reasonable suspicion that child abuse
has occurred, you don't even have to have
proof, you should call child-line and
report it. It doesn't mean that child
will automatically be yanked out of
their home, it means that a professional
social worker will investigate what's
happening with that child. It may be that
the family is just stressed and has a
lot of needs it may be that there is
very seriously something happening to
that child and a major intervention
needs to happen. We as normal lay people
in the public and even doctors and
nurses, we don't do that investigation we
require those professional social
workers to do that but it's important
because you cannot break the cycle of
child abuse unless you report it. And
that number for child-line is
1-800-932-0313 again that's 1-800-932-0313. We will
post that number in the comments section
below this Facebook post. This is Ask Us
Anything About Child Abuse Prevention
from Penn State Children's Hospital. I'm
Scott Gilbert along with Dr. Lori Frasier.
In case you're just joining us
we invite you to add your questions to
the comment field below this post.
We will post those to Dr. Frasier whether
you're watching this video live or even
if you're watching it on playback, we can
still get some answers to those
important questions for you. You know,
we're talking a bit about what to do if
you suspect, well let's take a step
backward what are some of the possible
signs and symptoms that a child could be
in trouble from the various forms of abuse?
Of course everybody recognizes
in many cases physical abuse when
children have injuries that might be due
to physical abuse that's one form of
abuse. Another form of abuse is sexual
abuse that's much more covert or hidden
form of abuse. We hear about that all the
time recently. There is neglect where
children are deprived of the necessities
of life, like shelter, clothing, food and
we've heard about that it's important if
you think a child has been deprived of
the necessities child neglect is
actually the most fatal form of child
abuse in the United States. So neglect
harms children just as much as physical
or sexual abuse. There's emotional abuse
and we've already had someone ask us
about verbal abuse which constitutes a
form of emotional abuse. Children are
harmed emotionally when they're subject
to severe yelling, name-calling, horrible
things being said to them, that is a form
of abuse that needs to be addressed. So
most abuse in Pennsylvania is actually
about 50% report is about sexual abuse.
In the United States, most abuse that's
reported is neglect. So we have a very
pretty good response to sexual abuse in
Pennsylvania and a high awareness.
Physical and abuse and neglect maybe not
so much. That's a comment on Facebook from one
of our earlier posts about this program
was from Gwen she had asked us or she
had just basically made a statement
saying that verbal abuse is indeed child
abuse and of course Dr. Frasier I know
you agree with that. My question would be
when it comes to those forms of abuse
for which there are no physical symptoms,
it would seem that those could be
tougher to spot for example neglect and
verbal abuse. Well correct, sometimes
neglect is hard to spot that I think
that is dependent upon the age and
the needs of the child. You know if you
spot a very young child out where they
may be harmed by running into traffic or
they're not dressed appropriately for
weather, that may be a very significant
form of neglect. Medical neglect is not
something that the lay public is going
to recognize. Nutritional neglect, if you
see children who are not allowed to eat,
who are deprived of food, who are
deprived of appropriate shelter, those
are also important things to report
because they can be very serious and
often neglect is part of a bigger
picture too. Emotional abuse it's hard in
the state here that includes verbal
abuse and other forms of emotional abuse
like; maybe you're not physically harming
a child but you're isolating them, you're
making them feel very badly about
themselves. Those forms of abuse need to
be proven by a licensed physician or
psychologist to show the emotional
damage that has occurred to those
children as a result of those actions. So
those are much more difficult forms of
abuse to prove but the step towards
proving it is reporting it. You're
watching Ask Us Anything About... Child
Abuse Prevention from Penn State
Children's Hospital. I'm Scott Gilbert,
along with Dr. Lori Frasier. We welcome
your questions and comments in the
comment field below this Facebook post
whether you're watching this video live
or on playback and also if you find this
information useful we encourage you to
share it on your Facebook feed. One of
the most nerve-wracking and perhaps
uncomfortable situations might be if
we're somewhere in public, say, it's in a
grocery store and we see what we believe
to be abuse being committed against a
child by a complete stranger. We might
feel helpless, might feel like there's
nothing we can do in that situation, what
should we do? I think that it's important
to address it if you feel like
you can address it with the parent, not
in a negative way but trying to assess
if what is happening is because the
parent is stressed out. Offering to help
a parent, trying to be supportive of
what's happening to a parent. It's very
hard sometimes in a store. Because
calling child-line on the spot doesn't do
anything to alleviate that situation.
Correct. So you might be able to
intervene if it's a situation that you
feel comfortable in a supportive way
that really shows that you want to help
that parent. Now, if you see a child who's
really in danger on the spot, you need to
call 911. That is most important. Children
and Youth will respond to child-line
reports but they're not a 911 response system.
If you think a child is physically being
harmed and you fear for that child
safety, you can call 911 and the police
will respond. On the other hand, maybe
it's just not up to your standard of
parenting. Right? It's maybe not abuse. It's
subjective right? Because, what's abused
to one person may not be to someone else.
Right and perhaps it's merely a
stressed-out parent or you know just
because you're yelling at a child isn't
automatically child abuse or emotional
abuse it needs to be much more
significant than just raising your voice
or maybe grabbing a child by the arm. Now
hitting or striking a very young child
would automatically be abuse. In our
state, [Pennsylvania] you can't hit a child under the
age of 1 for example. Or shaking a child
under the age of 1. So even without any
physical indicators those would
automatically be child abuse. And the
number for child-line again, again for a
non urgent but still pressing situation
when you want to get word to authorities
is 1-800-932-0313 and that number
is 24 hours a day. 1-800-932-0313. if
someone does call Child-line they might
then wonder how involved am I going to
be in this case am I going to receive
follow-up phone calls from investigators
might not have to go so far as to
testify. What are some of what some
advice you can give people in that
situation. Well every citizen is
guaranteed anonymity if they report. They
don't have to give their name, what they
do have to give is something that CYS
can identify and find a child. So you
have a
guarantee of anonymity if you're not in
a professional capacity and even
professionals can. Here at Penn State, we
actually provide our names and the
Center for the Protection of Children
physicians often are very involved in
the follow-up and the courtroom work. Not
every citizen wants to do that, that's
understandable. So you can be anonymous,
you can report anonymously. You know, you
lead the staff here of child abuse
pediatricians here at the Center for
the Protection of Children, can you
talk a bit about the center's services
just for folks that may not be that
familiar with it? Sure, so we have a variety
of services here. We are a group of
medical and mental health professionals
who work directly with children. From the
medical side of things we provide the
care of children who are abused who come
to Penn State Hershey or who are found
in the community and children and youth
may call us and ask us to evaluate
children's injuries. Which we may find
may be due to abuse or may not be due to
abuse. We have those medical skills as
pediatricians. The other thing that we do
is we have a clinic for children and
out-of-home placement at our TLC clinic
Transforming The Lives of Children
Clinic in Harrisburg. If children are
removed for some reason whether they're
placed in foster care kinship care, we
have a medical home for those children,
pediatrician who provides care. We also
have a mental health program that
provides the follow-up and mental health
services for children who are abused and
who are traumatized by something abuse
or neglect or other violence in the
community they might suffer from
post-traumatic stress disorder, we have
mental health programs for those
children at the TLC clinic in Harrisburg.
We also provide resources for parents
who might be engaged in harsh parenting
through fairly intensive parenting
interventions that require really
hands-on teaching of parents on how to
more positively parent. And we have a
program for children who might be
exhibiting sexual behavior problems and
to help them understand what's
appropriate and what's not. So we are,
and we're increasing our services all
the time two different modalities to
treat different kinds of children who
might be abused or neglected or
traumatized. Dr. Lori Frasier is the head
of the Center for the Protection of
Children here at Penn State. She's
joining us today for Ask Us Anything
About Child Abuse Prevention. I'm Scott
Gilbert we welcome your questions in the
comment field of this Facebook post. Like
I said before whether you're watching
this video live or if you're watching it
after the fact we'll track down an
answer for you. I would really like to
ask you a bit about a grant that Penn
State recently received from the
National Institutes of Health one of
your colleagues Dr. Ken Hymel is
integrally involved with this. And it
involves a clinical trial to test a tool
that doctors can use. Can you tell us
about that tool and how it plays into
these cases? Certainly it's about a
series of questions that a physician can
address when they see a child in the
pediatric intensive care unit. So, it's
not meant for just normal clinical use
it's specifically designed when children
come into the intensive care units
across the United States, what types of
questions do the physicians need to
address to either proceed with a full
workup for child abuse or realize the
child is at low risk. Understanding that
we have limited medical resources we
don't want to proceed with a full
medical workup for child abuse when it's
not indicated when that child has a
completely explainable problem, versus we
don't want to miss children who are
abused that may go on to be more abused
if they're sent home. So it's really
what's called the clinical decision rule
to help doctors sort through the complex
medical questions and his project is
really about implementation. It
partners with two other studies that
he's done to develop the clinical
prediction ruled clinical decision rule
and to move forward with spreading it
out through the different pediatric
intensive care units in the United
States. As part of a larger 7.7 million
dollar NIH grant the Penn State is
received. You can find more information
on that grant and the project of Dr.
Hymel at
PennStateHealthNews.org a story we posted
just earlier this week about that. Dr.
Lori Frasier, I need to ask you your job
seems like it would be very difficult to
do what you do. What inspires you to keep
coming back each and every day to help
children and do what you do. Well, we see
them get better, we see them protected, we
make the right decisions, we hope, and
many times we're the team that says the
children are not abused. We find another
explanation. So our expertise allows us
to make accurate diagnosis and then we
have other programs where children can
be followed up, they can receive mental
health services, parents can receive
services. I enjoy education which is why
I'm part of Penn State Hershey College
of Medicine. I teach medical students. I
teach residents. I work in the community
to educate law enforcement as well as
Children and Youth in the medical
aspects of child abuse. It's a wonderful
job to have that allows you to be part
of the community that you live in. In
more ways than I think other forms of
medicine do. Very important work.
Dr. Lori Frasier, thank you for your time.
Thank you very much Scott. Dr. Lori Frasier
is a child abuse pediatrician and
director of the Penn State Center for
the Protection of Children. She joined us
for this edition of Ask Us Anything
About. We welcome your questions, your
comments, add them to the comment field
even if you're watching this video on
playback, we'll be happy to respond and
get you some answers. And also of course,
feel free to share this interview if you
felt that the information was worthwhile.
I did and I hope you do too and I appreciate
you watching this edition of Ask Us
Anything About... Child Abuse Prevention
from Penn State Health.