Fort Worth, Texas,
05:04 PM

Child Abuse: When and How To Report

If you suspect child abuse, report it. Learn when and how to report.

Child abuse is a difficult subject to think about, much less discuss with your family and friends. But it also can’t be ignored.

Jamye Coffman, M.D., medical director of the Child Advocacy Resource and Evaluation (CARE) Team at Cook Children’s, says if we don’t talk about the issue, change won’t ever occur.

“Children are dependent on adults so it’s up to us to make sure they are protected and taken care of, regardless if they are our children or not,” Dr. Coffman said.

Tarrant County has the highest confirmed child abuse rate of all urban counties in Texas. In 2015, there were 6,123 confirmed child abuse cases in Tarrant County and 16 fatalities.

“It makes me very sad for our children,” Dr. Coffman said. “We don’t know how many of these kids are first time confirmed victims or if this is confirmed, repetitive abuse. The biggest misperception about abuse is that it doesn’t happen, because nobody wants to believe that it is in their neighborhood or family.”

There are many forms of child abuse, and each one has different signs that accompany it. The three main types of maltreatment are neglect, physical abuse, and sexual abuse.


The most common form of maltreatment is actually neglect, which is defined as failure to provide adequate food, clothing and shelter. Children who are neglected are often underweight and/or unkempt. They may beg for food or eat out of a trashcan at school; or they may be dirty, have dirty clothes and have a bad odor. For infants, underweight or malnourished, unbathed and dirty or severe diaper rash can all be signs of neglect. Neglect, especially in children under the age of 3, can cause the same long-term chronic health problems as being physically or sexually abused.

Physical Abuse

Children around 2 years of age and infants are at the highest risk for physical abuse as well. They are at the highest risk because they are not yet in school, and are therefore isolated. Due to their isolation, they have the highest mortality rate. The most common trigger of abuse for infants is crying, and then the “terrible twos” are where children are being “potty” trained and are beginning to say “no” and be more headstrong.

The thing to look for with physical abuse is abnormal bruising. Any bruise on an infant is concerning because they are not mobile enough to bruise themselves, so if a bruise occurs it’s more than likely that someone else had to have had a part in it. For older children the concerning bruises are ear bruises, bruises on the padded parts of the body or the cheeks, and anything from the hips to the shoulders, on any side of the body (excluding the hip bone). If the child has bruises on the bony prominences such as forearms, shins, elbows, knees, forehead, nose or chin, those could all come from normal play that the child engages in and are not as concerning.

Other things to be looking for are pattern bruises anywhere on the body, which means anything that looks like an object such as a belt, switch or spoon. Similar to this are burns. If there is an emersion type burn on a child as if they had put a whole body part into hot water, that is also concerning. This is different from an accidental burn. Those types of burns, such as pulling a pot of hot water off the stove, would have a splash pattern from all the places the water went, whereas an emersion burn has a distinct pattern that usually looks like a glove or sock pattern. This means that their body was placed into hot water and was forced to stay there long enough for severe burns to form.

Sexual Abuse

Sexual abuse, unlike physical abuse and neglect, does not have many specific symptoms or behaviors. Some physical signs of sexual abuse, however, could include trauma or damage to the genital or anal areas, sexually transmitted diseases, or pregnancy.

Children may act out with sexual or inappropriate behavior that is beyond their expected developmental knowledge. This may indicate the child has witnessed or experienced the sexual behavior.

The most important thing for a sexually abused child’s healing process is having a supportive parent. Having a parent believe them, and support them, is crucial for their mental health.


Get Involved

Children, especially small children, don’t have a way to get help for themselves, so the adults around them, need to help them by reporting the abuse. Dr. Coffman still believes reporting cases to Child Protective Services can make a difference in helping a child. All reports to Child Protective Services are confidential and CPS will not tell the family who called in the report.

Basic things needed when reporting child abuse:

  • Name of the child
  • Name of the parents
  • Address and phone number where the child is located
  • Any information you have regarding the abuse
  • Who the reporter believes the abuser to be
    • Abuser’s name
    • Contact information

If any other children may be at risk of abuse

Once a call is made, CPS can either decide to take the case and begin an investigation or they can determine there isn’t enough information to open a case. If CPS opens a case, and it turns out that there is no abuse found, you as the reporter cannot be sued if you reported in good faith. The case will just be closed.

Additionally, calling CPS does not automatically mean that the child will be removed from the family. CPS may be able to provide services for the family such as daycare, parenting classes, anger management services and drug or alcohol rehabilitation so that the child can stay with their family, or at the very least be reunited with their family. The ultimate goals of CPS are keeping children safe and making sure the child has a permanent home with the family or a relative if possible.

“These children are at increased risk of long-term poor health and early death,” Dr. Coffman said. “It is our moral responsibility, as well as economic responsibility to act now; to put our children first and get involved. It’s going to take a consensus that this is a priority in our community and in our state. I have faith that we can do better and that people care enough to work together to improve the future of our children."

More about the CARE Team

Child abuse is never an easy topic to talk about. But we cannot afford to ignore it. As part of our promise, the Child Advocacy Resources and Evaluation (CARE) Team is dedicated to creating a safer, healthier community for all children that we serve, and that includes providing the care, support, and tools to bring an end to child abuse. Click here to learn more.

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