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Health & Exercise Forum

Recognizing and Reporting Child Abuse: Part 1 of 2

Mar 30, 2015

Dr. Mackarey's Health & Exercise ForumThe Commonwealth Medical College will present: The 3rd Annual Keystone Program “Child Abuse Symposium 2015”

In an effort to address the horrific problem of child abuse, TCMC, along with The Children’s Advocacy Center/NEPA, Lackawanna County Medical Society, and Luzerne County Medical Society, with host the 3rd Annual Keystone SymposiumSpring 2015 – “Child Abuse – Recognizing & Reporting”on Saturday April 11, 2015 at the Radisson Lackawanna Station Hotel from 8 AM until 12:30 PM.

The purpose of the symposium is to provide strategies for health professionals and students to recognize and report child abuse. As of 2015, it is mandatory for licensed health professionals to receive continuing education credits for license renewal. For more information about the symposium contact: Gloria Colosimo at TCMC 570-504-9074 or email

“Health & Exercise Forum” will dedicate the next two weeks presenting columns on topics related to this unconscionable problem on the local, state and national level.  

CHILD ABUSE: Part 1 of 2

Guest Author: Anjani Amladi, MD4

Anjani Amladi

Anjani Amladi

AnjaniAmladi is a 4th year medical student at The Commonwealth Medical College (TCMC). She was raised in San Ramon, CA and earned a B.S. in Biological Sciences at The University of California at Davis. She plans to become a Psychiatry Resident and specialize in child/adolescent psychiatry. 

Anjani is the recipient of the 2014/15 TCMC Healthcare Journalism Award by Dr. Paul Mackarey.


Child Abuse - The Problem

Every ten seconds a report of child abuse is made in the United States.This adds up to more than 3 million reports involving greater than 6 million children per year. More than five children die every day as a result of child abuse and most are under the age of four. About half of the cases of child fatalities due to abuse/mistreatment are not reported on death certificates. Though it may be easy to convince ourselves that child abuse or mistreatment does not happen in our own back yards, the sad part is that it happens everywhere. Child abuse occurs at every socioeconomic level, educational level, across ethnic and cultural lines, and yes in small, quite cities and towns in NEPA. In fact, the Children’s Advocacy Center, Lackawanna County’s designated child abuse center, provided services to 1,448 children and adolescents in 2014. Of these, 80% experienced sexual abuse, 16% experienced physical abuse, and the remaining 4% experienced a combination of both physical/sexual abuse and/or severe neglect.

Title 23 Chapter 63 (Domestic Relations), also known as the Child Protective Services Law, has undergone many recent changes which went into effect as of January 1, 2015. Perhaps the most important changes are lowering the threshold of what constitutes child abuse, increasing the list of who is defined as a mandatory reporter, clarifying the mandatory child abuse reporting process, and providing increased education to people who are defined by law as mandatory reporters.

Definition of Child Abuse – Child Protective Services Law – Title 23 Chapter 63

Pennsylvania law defines child abuse as intentionally, knowingly or recklessly doing any of the following:

(1)  Causing bodily injury to a child through any recent act or failure to act.

(2)  Fabricating, feigning or intentionally exaggerating or inducing a medical symptom or disease which results in a potentially harmful medical evaluation or treatment to the child through any recent act.

(3)  Causing or substantially contributing to serious mental injury to a child through any act or failure to act or a series of such acts or failures to act.

(4)  Causing sexual abuse or exploitation of a child through any act or failure to act.

(5)  Creating a reasonable likelihood of bodily injury to a child through any recent act or failure to act.

(6)  Creating a likelihood of sexual abuse or exploitation of a child through any recent act or failure to act.

(7)  Causing serious physical neglect of a child.

(8)  Engaging in any of the following recent acts:

(i)  Kicking, biting, throwing, burning, stabbing or cutting a child in a manner that endangers the child.

(ii)  Unreasonably restraining or confining a child, based on consideration of the method, location or the duration of the restraint or confinement.

(iii)  Forcefully shaking a child under one year of age.

(iv)  Forcefully slapping or otherwise striking a child under one year of age.

(v)  Interfering with the breathing of a child.

(vi)  Causing a child to be present at a location while a violation of 18 Pa.C.S. § 7508.2 (relating to operation of methamphetamine laboratory) is occurring, provided that the violation is being investigated by law enforcement.

(vii)  Leaving a child unsupervised with an individual, other than the child's parent, who the actor knows or reasonably should have known:

(A)  Is required to register as a Tier II or Tier III sexual offender under 42 Pa.C.S. Ch. 97 Subch. H (relating to registration of sexual offenders), where the victim of the sexual offense was under 18 years of age when the crime was committed.

(B)  Has been determined to be a sexually violent predator under 42 Pa.C.S. § 9799.24 (relating to assessments) or any of its predecessors.

(C)  Has been determined to be a sexually violent delinquent child as defined in 42 Pa.C.S. § 9799.12 (relating to definitions).

(9)  Causing the death of the child through any act or failure to act.

Mandatory Reporting

For years, the designation of a mandatory reporter and the process in which to make a report has been cloudy to say the least. The new law defines a mandatory reporter as anyone who meets the following criteria: a person who is certified or licensed to practice in any health-related field, a medical examiner, coroner, or funeral director, an employee of a health care facility or medical provider that is responsible for the care or treatment of individuals, school employees, an employee of a child care service who has direct contact with children, a clergyman, priest, rabbi, minister, Christian science practitioner, religious healer or spiritual leader of any established church or religious organization, any individual paid or unpaid who accepts responsibility for a child (youth coaches, troop leaders, etc.), employees of a social services agency who have direct contact with children, a peace officer or law enforcement officer, emergency medical services providers, an employee of the public library that has regular contact with children, and independent contractors.

A mandated reporter is required to make a report of suspected child abuse if there is reasonable cause to suspect that a child may be being abused. An oral or written report must be completed and submitted within 48 hours to the state.

Increased Education Among Medical Practitioners

Act 31, an amendment to the Child Protective Services Law, requires that further training be provided for mandatory reporters. The law requires that anyone with direct contact with children or an executive/facility director who provides services for care of children that are applying for a license or certification must complete at least three hours of approved child abuse training; including foster parents. Additionally, anyone who is renewing a license or certification must complete at least two hours of continuing education per licensure cycle. At a minimum, the training must cover recognition or signs of child abuse, as well as reporting requirements for suspected or witnessed child abuse.

Where and How to Report Child Abuse

ChildLine: 1-800-932-0313

Children’s Advocacy Center: 1710 Mulberry Street Scranton, PA 18510 570-969-7313

National Child Abuse Hotline: 1-800-4-A-CHILD

Other Resources:

MEDICAL REVIEWER: Karen Arscott, DO, Associate Clinical Professor in Clinical Sciences; The Commonwealth Medical College.

Read Dr. Mackarey’s Health & Exercise Forum in the Scranton Times-Tribune. Next Monday: Child Abuse - Part 2 of 2

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email:

Paul J. Mackarey PT, DHSc, OCS is a Doctor  in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at The Commonwealth Medical College.