How To Identify And Report Child Abuse

Tawna Roberts, OD, PhD, FAAO shares her experience as a pediatric optometrist and how to identify and report child abuse.

Cara Moore: Hi everybody. Thanks for joining us here on Optometry TV, I’m Cara Moore joined now by Dr. Tawna Roberts, a Pediatric Optometrist. Thanks for being here.

Dr. Tawna Roberts: Thanks. Thanks for having me.

Cara Moore: So we are talking about identifying and reporting child abuse. So first of all, start us off with things that an optometrist should be looking for, ways to maybe identify some addition, some initial warning signs.

Dr. Tawna Roberts: And so the biggest issue with kids typically with child abuse that we’re going to see are signs of neglect. So kids that don’t appear to be well taken care of, they’re not well bathed, they have a lot of times they’ll have a lot of Blepharitis, etcetera around their lids and lashes, and they’re just not getting bathed appropriately, that kind of thing. The other thing is delayed medical treatment so they’re not being brought into the doctor as quickly as they should be or they’re not following protocols and treatment, management¬† decisions that we’ve put out for them. So, that’s really specifically important for kids with lazy eye, who aren’t getting the treatment that they should because the parents are, you know, quote unquote neglecting their either medical care or their personal care and hygiene. And the other thing that we really need to be on the lookout for is sort of bruises that don’t make sense. So little kids are quite clumsy and they fall a lot, so it’s very common to be bruised on like their elbows or their knees. But it’s not common to have bruises on soft tissue areas of the arm or the upper arm or the thigh, things like that. So when there’s things that don’t quite make sense and they don’t fit in the way we expect to see little kids playing in rough housing, then that’s when we need to be concerned.

Cara Moore: So what if a practitioner suspects something? Right? What steps can he or she take?

Dr. Tawna Roberts: Yeah, so it’s always a little bit awkward because practitioners, I think we always feel like, Oh, what if we’re wrong? What if it’s not really child abuse? I don’t want to report this, but I think what’s really important is that we have to remember that we’re mandated reporters, but more importantly, we’re advocates for the children. And so the first thing that you want to do is to contact child protective services. If it’s a situation where you don’t think the child is in immediate danger, if the child you think is in immediate danger, then the first thing you should do is call the police. And then, you know, we’ll talk a little bit at the lecture tomorrow about should you tell the parents, should you not tell the parent that you’re calling child protective services? And a lot of the literature actually suggest that you do talk to the parent and let them know and explain to them what you’re seeing and that it’s, that you are a mandated reporter and you need to call child protective services. But this is all because you’re trying to protect their child. And, and that, a lot of times that helps to save your relationship with the family. And because they know it’s expecting, it’s expected, it’s not out of the blue. And, and that typically, most of the research shows that that’s actually better for the practice, better for the provider, and better for the parent. And a lot of those relationships of the parent patient relationship with the Doctor is salvage that way.

Cara Moore: So having that conversation that might seem a little awkward at first.

Dr. Tawna Roberts: Yeah. Yeah, it’s very awkward, you know, I’ve had to report child abuse on a couple of different occasions and the first time, you know, I really knew nothing about it, which is why I’ve done a lot more research to be able to talk on the topic and I didn’t tell the parent and it was really bad. And so, when child protective services showed up at their house to do an investigation, it wasn’t a secret that I was probably the one that reported them. And since then and doing a lot of the research that I’ve done and worked with people that do, talk to people with child protective services and stuff, they recommended that if I ever had to do this again, I actually communicate that with the parent. And so the subsequent times that I’ve had to report that I’ve done so, and it has been a much better experience all around for not just for me but for the family, and they remain my patient. And you know, the kid was taken care of and everything was okay. I mean, the goal is to protect the child and the goal is not so always remove the child from the parents. It’s to get that family in a position where, you know, whatever the stresses that may be causing these things that happen are helped and taken care of. And so by communicating that with a family, they know you’re doing it for the right reasons and it really helps to salvage all those relationships because even parents who oftentimes, unfortunately, maybe it might be the parent that’s responsible for the abuse itself, they really care about their kids. And so there’s a lot of, you know, sort of back things that are happening, why the abuse may have happened in the first place. But the point of child protective services is to advocate for the child. And a lot of times they don’t remove the child from the home. They help the parents get the help that they need to make sure that the child is taken care of. And so it’s just better all around if everybody’s communicating and open about that.

Cara Moore: So basically the message is don’t be afraid to report it and don’t be afraid to have the conversation.

Dr. Tawna Roberts: Yeah. Don’t be afraid to have the conversation. You don’t have to. It’s advised. But you definitely need to report it. I mean, we have to be the advocates for the child and it’s uncomfortable. I mean, I’m not going to lie. I’ve had to do it a few times. It’s uncomfortable, but it’s really important for the kids.

Cara Moore: All right. We appreciate your time, Doctor Roberts.

Dr. Tawna Roberts: Thank you very much.

Cara Moore: And thanks for watching Optometry TV.

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