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Child abuse signs are identifiable

April is National Child Abuse Prevention Month. One focus this month is the emphasis on awareness of child abuse and neglect and their impact on children.

Parents and other caregivers provide children with their first understanding of themselves. Children learn self-acceptance, love, security and curiosity in an environment that nurtures growth and development.

Infants and toddlers depend on having a secure emotional attachment to an adult on whom they know they can depend for physical and emotional needs.

Children who do not have this or are exposed to violence, neglect or parental substance abuse are at risk for mental health problems. Nationally, one-third of 2- to 5-year-olds in child welfare need mental health services.

As a physician and foster parent, I am required by law to file a report with the Washington State Department of Social and Health Services if I suspect a child is being abused or neglected.

Everyone would like to think they would do their best to protect a child, but perhaps you would not be confident enough in your ability to recognize abuse and neglect, or you might be concerned about how your report might affect the child’s caregiver.

Here are some general signs of child abuse and neglect:

•Showing sudden changes in behavior or school performance.

•Not receiving help for physical or medical problems brought to the parents’ attention.

•Having learning problems (or difficulty concentrating) that cannot be attributed to specific physical or psychological causes.

•Being always watchful, as though preparing for something bad to happen.

•Lacking adult supervision.

•Being overly compliant, passive or withdrawn.

•Coming to school or other activities early, staying late and not wanting to go home.

You may also see things that are specific to physical abuse, neglect, sexual abuse or emotional abuse. Some abused or neglected children look and act like normal kids, but you may notice the behavior of the adult who is harming the child or something about how the adult and child interact with each other.

A good place on the Internet to find guidance for recognizing child abuse is Once there, click on “What is Abuse?” on the right-hand side of the page.

You can also call the Childhelp® National Child Abuse Hotline at 800-4-A-CHILD (800-422-4453) and push “1” to ask questions about child abuse and neglect.

If you do believe you have seen signs of child abuse or neglect, call Washington state’s toll-free, 24/7 hotline at (866) ENDHARM (866-363-4276). They will connect you to the appropriate local Department of Social and Health Services office so that you can report suspected child abuse or neglect.

Once a report has been made, Child Protective Services will determine if the report meets the criteria for investigation. If it does, CPS will determine whether the child is in imminent danger, who is responsible and what actions are appropriate to protect the child from further harm.

Intervention by CPS does not automatically mean that a child will be removed from the home. It may be determined that home support specialist services; day care; financial and employment assistance; parent aides; mental health services (for parents and children); parenting classes and/or family preservation services will be the most beneficial response for the child and the family.

Reports not meeting the Washington state law definition of child abuse or neglect are not investigated further. However, they are kept on file and may be referred to in the future if there are further reports submitted about a given child.

Our Kids: Our Business is a local movement focusing on children in our community by uniting social services, nonprofits, businesses and the media. This movement’s symbol is the pinwheel and you will see them around town this month.

Watch the Spokesman-Review or go to for Our Kids: Our Business events throughout April.

Protecting children is everyone’s business, and reporting suspected abuse or neglect can save a child’s life.

Learn the signs of child abuse and neglect. Take a child seriously if he or she tells you about abuse or neglect. Report any known or suspected incidents.

We can all make a difference in the lives of children in our community and we all need to take the responsibility to do so.

Dr. Alisa Hideg is a family medicine physician at Group Health’s Riverfront Medical Center in Spokane.