DFCS Online Policies & Procedures

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Handbook 3: Assessment Guides
3-2 Allegation Guide II:  Mental/Emotional and Substance-Related Maltreatment
Assessment Guides
3-2  Allegation Guide II: Mental/Emotional and Substance Related Maltreatment
Reference Points
Harassment/Ridicule
Inappropriate/Excessive Restraint
Excessive Use of Confinement/Isolation
Bizarre/Cruel Punishment
Other/Mental Injury
Newborn Prenatally Exposed to Substance Abuse
Substance Misuse by Child (Allowed or Forced)
Improper Administration of Drug
Giving Poison/Noxious Substance
Other Substance Related Harm


Reference Points
Effective Date: 03/01/06
Last Updated: 12/30/05


Mental/Emotional Maltreatment:  Harassment/ Ridicule  

Harassment/Ridicule

  • Description
    Verbal mistreatment which results in an impairment to the child's intellectual or psychological capacity as evidenced by observable and substantial reduction in the child's ability to function within a normal range of performance and behavior, with due regard to the child's culture and age.
  • Guidelines
    Some indicators, taken separately, are not necessarily symptomatic of abuse, neglect or exploitation. They must be examined within the context of other characteristics of the family to determine whether or not the child is at risk.
    Verification of this allegation may come from any or all of the following, depending on the conduct alleged: a medical, psychiatric or psychological opinion; statements of law enforcement officer, CSW, witness(es) or the child; or, direct admission of alleged perpetrator.


  • Factors to Consider
    • Child's age (children age 6 years and younger are at much greater risk of harm).
    • Child's medical condition; behavioral, mental and emotional problems; developmental disability; or, physical handicap, particularly as they relate to child's capacity for self-protection.
    • Pattern or chronicity of similar incidents.
    • Severity of this incident.
    • Previous history of indicated or confirmed abuse or neglect.
    • Does the child exhibit: behavioral extremes of fear, compliance, passivity or aggression; overly adaptive behavior, e.g., being inappropriately adult or inappropriately infantile; developmental lags, runaway or suicidal behavior; or, enuresis or encopresis?
    • Did this harm/injury/maltreatment occur as the result of an action or lack of action which:

      1) meets CDSS' definitions of abuse, neglect or exploitation and

      2) is directly attributable to the child's parent or legal guardian?

    • Did the parent or legal guardian:

      1) personally commit the harmful act,

      2) condone or permit a harmful act by other persons in circumstances in which it would be reasonably possible to prevent the harm, or

      3) force, allow or coerce the child to commit harmful acts?

  • Most Likely Classifications
    Is/was this harassment/ridicule:
      • the result of a parent/legal guardian inflicting nonphysical mistreatment which may be characterized by disturbed behavior by the child?- Abuse(Emotional)
      • the result of the negligent failure of a parent/legal guardian to provide adequate supervision where no physical injury has occurred? - Neglect(General)
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Mental/ Emotional Maltreatment:  Inappropriate/Excessive Restraint  

Inappropriate Excessive Restraint

  • Description
    Any physical actions or use of mechanical devices which create unreasonable restrictions on the child's mobility, actions or physical functions, pose actual or potential physical or mental harm and are not consistent with reasonable disciplinary standards. Examples include, but are not limited to:
    • Excessive physical force in restraining an acting-out child.
    • Tying one or more limbs to a bed or other object.
    • Tying the hands behind the back.
    • Tethering a child with adequate supervision.
    • Using a gag on a child.
     
  • Guidelines
    Some indicators, taken separately, are not necessarily symptomatic of abuse, neglect or exploitation. They must be examined within the context of other characteristics of the family to determine whether or not the child is at risk.

    Verification of this allegation may come from any or all of the following, depending on the conduct alleged: evidence from a physical examination by a physician; a medical, psychiatric or psychological opinion; statements of law enforcement officer, CSW, witness(es) or the child; or, direct admission of alleged perpetrator.

    If the alleged perpetrator contends that the restraints imposed were recommended by a medical or mental health practitioner as a means to ensure the child's safety or control or correct the child's behavior, the CSW must obtain verification from that medical or mental health practitioner. However, an abusive practice which was recommended by a medical or mental health practitioner should still be treated as abuse.
  • Factors to Consider
    • Child's age (children age 6 years and younger are at much greater risk of harm).
    • Child's medical condition; behavioral, mental and emotional problems; developmental disability; or, physical handicap, particularly as they relate to child's capacity for self-protection.
    • Pattern or chronicity of similar incidents.
    • Severity of this incident.
    • Location of injuries.
    • Whether an implement was used.
    • Previous history of indicated or confirmed abuse or neglect.
    • Does the child exhibit: behavioral extremes of fear, compliance, passivity or aggression; overly adaptive behavior, e.g., being inappropriately adult or inappropriately infantile; developmental lags, runaway or suicidal behavior; or, enuresis or encopresis?
    • Did this harm/injury/maltreatment occur as the result of an action or lack of action which 1) meets CDSS' definitions of abuse, neglect or exploitation and 2) is directly attributable to the child's parent or legal guardian?
    • Did the parent or legal guardian:

      1) personally commit the harmful act,

      2) condone or permit a harmful act by other persons in circumstances in which it would be reasonably possible to prevent the harm, or

      3) force, allow or coerce the child to commit harmful acts?  

The location of any surface skin marks may help to verify these allegations. Marks encircling the wrists, ankles or neck may be the result of having been tied. Multiple bruises extending out or down from the corners of the mouth may be the result of having been gagged.


  • Most Likely Classifications
    Is/was this inappropriate/excessive restraint:
    • the result of a parent/legal guardian inflicting a non accidental injury? - Abuse(Physical)
    • the result of the victimization by a parent/legal guardian of a child by sexual activities? - Abuse(Sexual)
    • the result of the negligent failure of a parent/legal guardian to provide adequate supervision where no physical injury has occurred? - Neglect(General)
    • the result of a parent/legal guardian negligently or willfully causing or permitting the person or health of the child to be placed in a situation such that his/her person or health is endangered through the failure to provide adequate supervision where physical injury has occurred? - Neglect(Severe)
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Mental/Emotional Maltreatment:  Excessive Use of Confinement/Isolation

 

Excessive Use of Confinement/Isolation

  • Description

Forcing a child to remain in a closely confined area which restricts physical movement in circumstances which pose actual or potential physical or mental harm and are not consistent with reasonable disciplinary standards. Examples include, but are not limited to:

  • Refusing to allow the child to speak with or be in the company of others for an unreasonable period of time.
  • Locking or otherwise requiring a child to remain in a room for an unreasonable period of time.
  • Locking or otherwise requiring a child to remain in a closet for any period of time.
  • Locking or otherwise requiring a child to remain in a place in which the child cannot move and/or breathe, such as a footlocker or an abandoned refrigerator, for any period of time.
  • Guidelines
    See Guidelines for C-31.
  • Factors to Consider
    See Factors to Consider for C-31.


  • Most Likely Classifications
    Is/was this excessive use of confinement/isolation:
    • the result of a parent/legal guardian inflicting nonphysical mistreatment which may be characterized by disturbed behavior by the child? - Abuse(Emotional)
    • the result of the negligent failure of a parent/legal guardian to provide adequate supervision where no physical injury has occurred? - Neglect(General)
    • the result of a parent/legal guardian negligently or willfully causing or permitting the person or health of the child to be placed in a situation such that his/her person or health is endangered through the failure to provide adequate supervision where physical injury has occurred? - Neglect(Severe)
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Mental/Emotional Maltreatment:  Bizarre/ Cruel Punishment  

Bizarre/Cruel Punishment

  • Description
    Acts of sadistic torture called "punishment" by the alleged perpetrator. Examples include, but are not limited to:
    • Deliberately scalding or burning the child.
    • Tying up the child in a position which causes extreme pain.
    • Forcing the child to witness an act of extreme cruelty, such as the killing of the child's pet.
    • Forcing the child to perform a humiliating/degrading act as a disciplinary measure [as opposed to doing so for the parent's amusement. See I-91, Compelling Inappropriate Acts (Non-Sexual)].
     
  • Guidelines
    See Guidelines for Inappropriate/ Excessive Restraint.


  • Factors to Consider
    • Child's age (children age 6 years and younger are at much greater risk of harm).
    • Child's medical condition; behavioral, mental and emotional problems; developmental disability; or, physical handicap, particularly as they relate to child's capacity for self-protection.
    • Pattern or chronicity of similar incidents.
    • Severity, location and number of injuries in this incident.
    • Whether an implement was used.
    • Previous history of indicated or confirmed abuse or neglect.
    • Did this harm/injury/maltreatment occur as the result of an action or lack of action which:

      1) meets CDSS' definitions of abuse, neglect or exploitation and

      2) is directly attributable to the child's parent or legal guardian?

    • Did the parent or legal guardian:

      1) personally commit the harmful act,

      2) condone or permit a harmful act by other persons in circumstances in which it would be reasonably possible to prevent the harm, or

      3) force, allow or coerce the child to commit harmful acts?

This category shall be used to describe extreme examples of actions which would otherwise be described under Inappropriate/ Excessive Restraint and Excessive Use of Confinement/Isolation.


  • Most Likely Classifications
    Is/was this bizarre/cruel punishment:
    • the result of a parent/legal guardian inflicting a non-accidental injury? - Abuse(Physical)
    • the result of a parent/legal guardian inflicting nonphysical mistreatment which may be characterized by disturbed behavior by the child?- Abuse(Emotional)
    • the result of the negligent failure of a parent/legal guardian to provide adequate supervision where no physical injury has occurred? - Neglect(General)
    • the result of a parent/legal guardian negligently or willfully causing or permitting the person or health of the child to be placed in a situation such that his/her person or health is endangered through the failure to provide adequate supervision where physical injury has occurred? - Neglect(Severe)
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Mental/Emotional Maltreatment:  Other Mental Injury  

Other Mental Injury

  • Description
    Any verbal or physical mistreatment which results in impairment to the child's intellectual or psychological impairment as evidenced by observable and substantial reduction in the child's ability to function within a normal range of performance and behavior, with due regard to the child's culture and age and which is not described under Harassment/Ridicule, Inappropriate/ Excessive Restraint and Excessive Use of Confinement/Isolation.

    Mental injury may result from:
    • Malicious repeated acts or statements directed at the child. Such behavior is often a pattern; however, such behaviors may also be episodic and equally injurious.
    • Exposure to repeated violent, brutal or intimidating acts or statements among household members or against other persons.
    • Malicious or violent acts directed toward a child's possessions, pets or environment.
    • Crude, brutal or drastically misguided actions used in an attempt to gain submission, enforce maximum control or modify the child's behavior.
    • Actions or verbal expectations which are inappropriate for the child's developmental level.
    • Actions which result in confusing the child's sexual identity.
    • Actions which severely and inappropriately restrict a child's autonomy or independent learning.
      
  • Guidelines
    See Guidelines for Harassment/Ridicule.


  • Factors to Consider
    See Factors to Consider for Harassment/Ridicule.


  • Most Likely Classifications
    Is/was this mental injury:
    • the result of a parent/legal guardian inflicting a non accidental injury? - Abuse(Physical)
    • the result of a parent/legal guardian inflicting nonphysical mistreatment which may be characterized by disturbed behavior by the child?- Abuse(Emotional)
    • the result of the negligent failure of a parent/legal guardian to provide adequate supervision where no physical injury has occurred? - Neglect(General)
    • the result of a parent/legal guardian negligently or willfully causing or permitting the person or health of the child to be placed in a situation such that his/her person or health is endangered through the failure to provide adequate supervision where physical injury has occurred? - Neglect(Severe)
    • the result of a parent/legal guardian forcing or coercing a child into performing functions which are beyond child's capabilities or capacities? - Exploitation
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Substance Related Maltreatment:  Newborn Prenatally Exposed to Substance Abuse  

Newborn Prenatally Exposed to Substance Abuse

  • Description

Newborns prenatally exposed to substance (i.e., drugs and/or alcohol) abuse may or may not exhibit symptoms of substance dependence and may or may not have positive toxicology screens. Therefore, when it is known or reasonably suspected that the mother was a substance abuser at any time during her pregnancy and there are concerns about her ability to provide appropriate ongoing care for her child whether or not she continues to be a substance abuser, the child shall be considered to be at risk of abuse or neglect.

Note that even if a newborn does exhibit symptoms of drug or alcohol withdrawal and/or positive toxicology screens, these facts alone are not sufficient grounds for a child protective services referral. The additional factor noted above (concerns about the mother's ability to care for the child) must be also present.

  • Guidelines
    Some indicators, taken separately, are not necessarily symptomatic of abuse, neglect or exploitation. They must be examined within the context of other characteristics of the family to determine whether or not the child is at risk.
    Newborns prenatally exposed to drugs/alcohol will test positive on toxicology screens only if the tests are conducted within specified time frames and geared to detect the specific substance which the mother used. Because of these limitations, false negatives are very common in infant toxicology screening.

    In addition, these children may show no signs of the damage they have suffered until they are later challenged developmentally or intellectually. Symptoms which do present at birth vary according to the substance to which they were prenatally exposed.

    Verification of prenatal exposure to substance abuse and the mother's ability to provide appropriate care for the child may come from any or all of the following, depending on the conduct alleged: evidence from a physical examination by a physician; a medical, psychiatric or psychological opinion; statements of law enforcement officer, CSW, witness(e's) or the child; or, direct admission of alleged perpetrator.
  • Factors to Consider
    • Child's age.
    • Child's medical condition; behavioral and mental problems; developmental disability; or, physical handicap.
    • Did this harm/injury/maltreatment occur as the result of an action or lack of action which:

      1) meets CDSS' definitions of abuse, neglect or exploitation and

      2) is directly attributable to the child's parent?

    • Did the parent:

      1) personally commit the harmful act,

      2) condone or permit a harmful act by other persons in circumstances in which it would be reasonably possible to prevent the harm, or

      3) force, allow or coerce the child to commit harmful acts?

    These children may be at risk of abuse and/or neglect due to lack of maternal bonding caused by the mother's addiction and/or the difficulty in caring for these infants. Whether or not the mother is successful in overcoming her addiction, the ongoing risk to the child must be evaluated in terms of these factors.

  • Most Likely Classifications
    Is this prenatal exposure to substance abuse of a newborn:
    • the result of a parent willfully causing or permitting the person or health of the child to be placed in a situation such that his/her person or health is endangered? - Neglect(Severe)
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Substance Related Maltreatment:  Substance Misuse by Child (Allowed or Forced)  

Substance Misuse by Child (Allowed of Forced)

  • Description

The consumption of a mood-altering chemical capable of intoxication to the extent that it substantially and harmfully effects the child's behavior, motor coordination or judgment. Mood-altering chemicals include cannabis (i.e., marijuana), hallucinogens, stimulants (e.g., cocaine), alcohol and other sedatives, narcotics or inhalants. Examples of substance misuse by a child include, but are not limited to:

    • Giving any mood-altering substance to an infant, unless as prescribed by a physician.
    • Encouraging, insisting on or permitting a young child or adolescent to consume alcohol, drugs or other mood-altering substance on a regular, frequent or daily basis, unless as prescribed by a physician.
    • Giving a child any illegal, illicit or controlled substance by encouraging, insisting or permitting the child to consume these substances, unless as prescribed by a physician.
     
  • Guidelines
    Some indicators, taken separately, are not necessarily symptomatic of abuse, neglect or exploitation. They must be examined within the context of other characteristics of the family to determine whether or not the child is at risk. Note that this category does not include the condition of drugs, alcohol or other harmful substances being left within the child's reach. That situation is covered in F-60, Hazardously Unsanitary Conditions.

    Verification of this allegation may come from any or all of the following, depending on the conduct alleged: evidence from a physical examination by a physician; a medical, psychiatric or psychological opinion; statements of law enforcement officer, CSW, witness(e's) or the child; or, direct admission of alleged perpetrator.


  • Factors to Consider
    The following shall be considered when determining whether a child is involved in substance misuse:
    • Age of the child.
    • Frequency of substance misuse.
    • Amount of substance consumption.
    • Whether the substance is illegal, illicit or controlled.
    • Degree of behavioral dysfunction or physical impairment linked to substance misuse.
    • Child's cultural background, particularly as it relates to use of alcohol in religious ceremonies or social occasions.
    • Parent's attempts to control or seek help regarding child's substance misuse.
    • Did this harm/injury/maltreatment occur as the result of an action or lack of action which:

      1) meets CDSS' definitions of abuse, neglect or exploitation and

      2) is directly attributable to the child's parent or legal guardian?

    • Did the parent or legal guardian 1) personally commit the harmful act, 2) condone or permit a harmful act by other persons in circumstances in which it would be reasonably possible to prevent the harm, or 3) force, allow or coerce the child to commit harmful acts?
     
  • Most Likely Classifications
    Did this allowed or forced substance misuse by the child occur as:
    • the result of a parent/legal guardian inflicting a non accidental injury? - Abuse(Physical)
    • the result of a parent/legal guardian willfully causing or permitting the person or health of the child to be placed in a situation such that his/her person or health is endangered? - Neglect(Severe)
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Substance Related Maltreatment:  Improper Administration of Drugs  

Improper Administration of Drugs

  • Description

Giving an over-the-counter or prescription drug to a child who does not medically require the drug, or exceeding or administering less than the medically proper or normal amount of a medically required over-the-counter or prescription drug without the advice of a physician to the extent that the child is unable to conduct daily activities in a coherent manner. Note that this category differs from Substance Misuse by Child in that Substance Misuse by Child shall be used for illegal, illicit and/or controlled drugs. Improper Administration of Drug shall be used when the substance being misused is a legal over-the-counter or prescription drug.


  • Guidelines
    Some indicators, taken separately, are not necessarily symptomatic of abuse, neglect or exploitation. They must be examined within the context of other characteristics of the family to determine whether or not the child is at risk.

    Verification of this allegation may come from any or all of the following, depending on the conduct alleged: evidence from a physical examination by a physician; a medical, psychiatric or psychological opinion; statements of law enforcement officer, CSW, witness(e's) or the child; or, direct admission of alleged perpetrator.


  • Factors to Consider
    The following should be considered when determining improper administration of a drug:
    • Alleged perpetrator's understanding about the proper use and dosage of the drug.
    • Did the child consume the drug without the parent's knowledge or consent?
    • Frequency of incidents.
    • Did this harm/injury/maltreatment occur as the result of an action or lack of action which:

      1) meets CDSS' definitions of abuse, neglect or exploitation and

      2) is directly attributable to the child's parent or legal guardian?

    • Did the parent or legal guardian:

      1) personally commit the harmful act,

      2) condone or permit a harmful act by other persons in circumstances in which it would be reasonably possible to prevent the harm, or

      3) force, allow or coerce the child to commit harmful acts?

  • Most Likely Classifications
    Was this improper administration of a drug:
    • the result of a parent/legal guardian inflicting a non accidental injury? - Abuse(Physical)
    • the result of a parent/legal guardian willfully causing or permitting the person or health of the child to be placed in a situation such that his/her person or health is endangered? - Neglect(Severe)
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Substance Related Maltreatment:  Giving Poison/Noxious Substance  

Giving Poison/ Noxious Substance

  • Description
    • Poison: Any substance including a noxious substance, other than mood-altering chemicals or alcohol, which when taken into the body by ingestion, inhalation, injection or absorption, interferes with normal physiological functions.
     
    • Noxious Substances: Substances other than mood-altering chemicals or alcohol which are injurious or harmful to the health. This would include drugs, food or other substances to which an individual is allergic or intolerant.
     
  • Guidelines
    Some indicators, taken separately, are not necessarily symptomatic of abuse, neglect or exploitation. They must be examined within the context of other characteristics of the family to determine whether or not the child is at risk.

    Verification of this allegation may come from any or all of the following, depending on the conduct alleged: evidence from a physical examination by a physician; a medical, psychiatric or psychological opinion; statements of law enforcement officer, CSW, witness(e's) or the child; or, direct admission of alleged perpetrator.


  • Factors to Consider
    Virtually any substance can be poisonous if consumed in sufficient quantity. The term "poison" often implies an excessive dosage rather than a category of substances. Aspirin, for example, is not usually thought of as a poison but overdoses of or adverse reactions to (e.g., Reyes Syndrome) aspirin kill more children accidentally than any of the traditional poisons. Likewise, a drug which is beneficial to most people can be deadly to an individual who is allergic to it.  
    • Did this harm/injury/maltreatment occur as the result of an action or lack of action which:

      1) meets CDSS' definitions of abuse, neglect or exploitation and

      2) is directly attributable to the child's parent or legal guardian?

    • Did the parent or legal guardian

      1) personally commit the harmful act,

      2) condone or permit a harmful act by other persons in circumstances in which it would be reasonably possible to prevent the harm, or

      3) force, allow or coerce the child to commit harmful acts?

  • Most Likely Classifications
    Was this giving of poison/noxious substance:
    • the result of a parent/legal guardian inflicting a non accidental injury? - Abuse(Physical)
    • the result of a parent/legal guardian willfully causing or permitting the person or health of the child to be placed in a situation such that his/her person or health is endangered? - Neglect(Severe)
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Substance Related Maltreatment:  Other Substance Related Harm  

Other Substance Related Harm

  • Description

Any other substance-related maltreatment, harm or injury to a child not described above.

  • Guidelines
    Some indicators, taken separately, are not necessarily symptomatic of abuse, neglect or exploitation. They must be examined within the context of other characteristics of the family to determine whether or not the child is at risk.

    Verification of this allegation may come from any or all of the following, depending on the conduct alleged: evidence from a physical examination by a physician; a medical, psychiatric or psychological opinion; statements of law enforcement officer, CSW, witness(e's) or the child; or, direct admission of alleged perpetrator.


  • Factors to Consider
    See Factors to Consider under Substance Misuse by Child (Allowed or Forced), Improper Administration of Drug and Giving Poison/
    Noxious Substance.
  • Most Likely Classifications
    Was this substance-related harm:
    • the result of a parent/legal guardian inflicting a non-accidental injury? - Abuse(Physical)
    • the result of a parent/legal guardian willfully causing or permitting the person or health of the child to be placed in a situation such that his/her person or health is endangered? - Neglect(Severe)
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