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Health & Exercise Forum

Recognizing and Reporting Child Abuse: Part 2 of 2

Apr 6, 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.  


Part 2 of 2

Anjani Amladi

Anjani Amladi

Guest Author: AnjaniAmladi, MD4

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.

This is the second in a series of two columns dedicated to the topic of child abuse. Last week we discussed the definition and laws related mandatory reporting. This week will present prevention, identification and reporting of child abuse.

The unfortunate truth is that child abuse is much more pervasive in our society than can be imagined. Although the natural reaction is to avoid an issue that makes us so uncomfortable, by treating child abuse in this manner we do ourselves and our children a great disservice. The most important lesson my Internal Medicine preceptor taught me during my third year medical school clerkship was, “the eyes do not see what the mind does not know.” The goal of this article is to help readers “see”…what child abuse looks like in order to prevent, recognize, and report this unconscionable act.

While knowing what to do after a child has been harmed is vital to the interventional and healing process, knowing how to prevent a possible event from occurring is even more important.

Preventing Child Abuse/Exploitation

Top 10 “Safety Rules” for parents and children:

  1. Talk to children about sexual abuse early, keeping their age and level of understanding in mind
  2. Teach children that they have “private areas” nobody is allowed to touch
  3. Explain to children that they can say “No” to an adult, and do not have to do anything that makes them uncomfortable
  4. Teach children not to accept gifts, give personal information, or get in a car with a stranger; And to tell someone immediately if they are approached by someone they do not know
  5. Be sure that a child knows how to call “911” if there is an emergency
  6. Teach children to never meet anyone in person who they met online
  7. Encourage open communication with children, and teach them to come to you if they have problems
  8. Teach your children that you will always believe them if they tell you they are being hurt or touched by someone – no matter who that someone may be.
  9. Be careful when selecting child care givers. Always check references of potential care givers.
  10. Teach children that it is never ok to answer the door when they are home alone, or to admit to anyone over the phone that they are home alone

Signs of Physical Abuse

  • bruises, welts, lacerations, or abrasions
  • sprains or broken bones
  • burns or bite marks
  • injury in the shape of an object ie. belt, handprint, iron
  • explanations for the injury is not consistent with physical findings, or explanation of the injury that keeps changing
  • medical attention for the injury was not obtained soon after injury
  • a child who attempts to hide injuries
  • a child who is reluctant to go home or has fear of caregivers

Signs of Sexual Abuse

  • genital pain, itching, or sexually transmitted disease
  • ripped, stained, or bloody clothing
  • difficulty sitting or walking
  • advanced sexual knowledge or sexual behavior inappropriate for age level
  • sudden personality or behavioral changes like hurting oneself ie. cutting, burning, drinking excessively or doing drugs

Signs of  Neglect

  • poor hygiene
  • clothing that does not fit or is inappropriate for the weather
  • lack of medical or dental care needs
  • a child who is constantly hungry and may beg or steal food
  • a child who avoids going home, may show up at school early and stay late, try to stay at other people’s homes

What do I do if my child tells me they have been abused?

While difficult, the most important  step is to remain calm. Children rarely lie about being abused – so believe what your child is telling you. Avoid interrogating the child, let them explain to you what happened in their own words. Immediately let the child know they did the right thing by telling you, and be sure to emphasize that the abuse was not their fault. After a child has disclosed the abuse, make a report to the police, local child protective services agency, or a child abuse hotline. It is imperative that this be done after the child is able to tell their story. Assure the child that they will be protected, and that no harm will come to them because they told the truth. Obtain counseling services for the child and for the family. It is important that the child have an advocate, but it is also important for a counselor to help families to process the trauma as well.

How to report 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 Professor in Clinical Sciences, The Commonwealth Medical College.

Read Dr. Mackarey’s Health & Exercise Forum in the Scranton Times-Tribune every Monday

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.