Detecting Child Abuse

What to Do

If you suspect child abuse or neglect:

Report to Child Protective Services if:

You don’t know who may have abused the child or you suspect a family member.

You suspect any type of neglect.

Report to Child Protective Services by phone: 1-800-252-5400, or online report: http://www.txabushotline.org

Report to law enforcement if:

• You suspect a non-family member is the abuser.
• You feel rapid intervention may be needed (severe abuse, threatening parents, fear of parent flight with child.)
• Note that a law enforcement report should be made to the agency with jurisdiction over the location where the abuse likely occurred—not necessarily where the child lives.
• Report to law enforcement by phone. Call your local law enforcement agency.
• Make the report as quickly as possible. When you make a report (either to CPS or law enforcement), be sure to record the case report ID number in the medical record.
• Consider whether other tests are needed.
• Consider whether hospitalization is needed: Serious injuries, especially in younger children and infants.
• To facilitate the abuse evaluation.
• To keep the child in a safe location pending further evaluation by CPS or law enforcement.
• Carefully and completely document any/all interactions with the child or parent, preferably in quotations.

How do you interact with the parent?

Stress your role to act in the child’s best interest to ensure they are safe.

If the abuser is unknown, but may be the parent, or the parent appears to be protecting an abuser, then you are not required to release verbal or written information to the parent if it may place the child in danger. This is an exception to the HIPAA rules.

What information can you release to CPS or law enforcement?

You can and should promptly release all information pertinent to the child’s injuries promptly to CPS or law enforcement, when they request it. This is also an exception to the HIPAA rules.

When to Call

When to call Center for Miracles

210-704-3800, Monday through Friday; 210-704-2100 after hours

You suspect abuse or neglect and want guidance on the next steps.

You have a question on which diagnostic tests might need to be done and whether a child might need to go to The Children's Hospital of San Antonio Emergency Room for forensic photo-documentation

Other questions we might be able to help with:

• “Does the history reasonably explain the injury(s) in this child?”
• “Is this appropriate or abusive punishment?”
• “Could this child’s failure to gain weight be due to neglect?”
• “What other non-abusive causes are possible?”

When to call ChildSafe

210-675-9000, Monday through Friday 8:00 a.m. to 5:00 p.m.

You suspect sexual abuse and want guidance on the next steps.

You have a question on whether a child needs a medical examination at ChildSafe, Center for Miracles, or The Children's Hospital of San Antonio Emergency Department.

To refer a child for a sexual abuse evaluation when the last incident of abuse occurred more than 96 hours ago.

When to call/refer to The Children's Hospital of San Antonio Emergency Department and/or Forensic Nurse Examiner program

210-704-2190, Seven days a week, 24 hours a day;

Ask for the Emergency Physician or Forensic Nurse Examiner on duty when:

• Sexual abuse may have occurred within the past 96 hours.
• The child is a suspected victim of sexual abuse or assault and has symptoms of ano-genital bleeding or pain.
• The child has visible injuries and is in need of forensic photo-documentation.