RECOGNIZING CHILD ABUSE AND NEGLECT IN TELEHEALTH CARE
December 22, 2020
Recommendations for Missouri Healthcare Providers
Among the many changes the COVID-19 pandemic has brought about, one of the greatest has been finding healthcare solutions for Missouri’s children and families through telehealth practices. This page is intended to support healthcare professionals in their efforts to support patients and keep children safe by preventing abuse and neglect. Despite these uncertain times, healthcare providers maintain a critical role in continuing to remain vigilant and report suspected child abuse and neglect.
While telehealth care poses new challenges, healthcare professionals should still assess patients as they would if they were seeing them in person and the following strategies may be helpful in addition to standard patient assessment procedures:
- Observe and consider family/child interactions. Does the child seem fearful of the caregiver? Does the caregiver speak for the child directly without allowing the child the opportunity to share?
- Observe any non-verbal cues that may be indicative of potential abuse and neglect. Does the child demonstrate expressions of pain despite any visible marks or bruises? Does the child seem shutdown? Do members of the home engage in traumatic play?
- Identify children on your caseload that were at a higher risk of potential abuse and neglect prior to COVID-19, as they may be especially more impacted now.
- If participating in video appointments, pay attention to the background. Are there any safety hazards, either physical or environmental? Can yelling and/or screaming be overheard? How does the child appear in the environment?
- Be mindful of who may be listening in the background. Ask probing questions such as, what does a day look like at home for you right now? What’s your favorite part about being at home? What is the hardest? Avoid yes and no questions if possible.
- Continue to assess suspicious injury or illness the same way you would in your office or clinic. Request photos of the injury via secure message to analyze and compare the appearance of the injury to how the parent reports it occurred.
- When discussing a suspicious mark with a child, make every effort to ensure the child is alone and can answer questions safely and confidentially.
- Listen to patient responses both verbal and non-verbal in their body language. Are patients or their parents and/or caregivers deflecting or avoiding responses to particular questions? Are parents and/or caregivers interrupting particular questions?
- Listen to how caregivers describe their interactions with their children. For example, a parent may say, “they are so ill-behaved, next time they act out I’m going to .”
- Ensure minor patients know how to reach out securely and confidentially should they need specific support, counsel or medical treatment that may be sensitive.
- For clinicians, create a safety plan and identify a safe word a patient/client can use to signal the presence of someone else whom they fear speaking in front of.
- Inform youth patients how they can access sexual and reproductive health resources, such as STD/STI screening and access to contraceptives, or other supportive services.
- Encourage patients to use self-care strategies for both mental and physical health. Provide some stress-relieving stretches, breathing techniques or physical activities for both children and parents.
- Utilize self-report assessments to assist in establishing a patient’s well-being, or to assist in identifying a wider understanding of what the patient is experience either physically or emotionally.