Happy month of October! This month, as the weather cools down, we would like to share with you some tools for motivating children to do well in school, healthy eating and its impacts, a Pumpkin Patch craft for kids and the first half of our new supervised visitation training manual chapter: “The Impact of Child Physical and Sexual Abuse on Supervised Visitation.”

We hope that you find these resources useful!

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Clearinghouse on Supervised Visitation
The Institute for Family Violence Studies
Florida State University

QUESTIONS FROM DIRECTORS
I am opening a new program. How can I determine how much annual salary a director makes?

Unfortunately, the answer is difficult to determine, because the Clearinghouse does not have such data. In addition, supervised visitation programs are very different around the state: many operate only part time. Other are open full time, but are associated with larger social services programs that set salaries. Still others are operated as free-standing non-profit entities in which the director’s salary varies with the funding that the program receives from external sources. One thing I can (and did) tell you is certain: directors of supervised visitation programs should not expect to have top-tier salaries. Visitation services are not money-making propositions, by and large.

How can I start entering data into the supervised visitation database if my program has not participated before?
Beginning Oct. 10, after the end of the statewide roll up, please call the office and we will give you training and a new password. (850-644-6303). Please wait until that data, as our staff is actively processing last year’s data.

My staff has been very interested in the research that the Clearinghouse has been presenting on trauma and its impact. Can you give me other resources so that I can do a “lunch and learn” with my staff?
Yes, but I would not recommend it be used over lunch. Learning about trauma can be upsetting and exhausting, so try to train staff in small doses. The Still Face Videos that teach social service providers the importance of parental interaction with babies and small children can be found on You Tube. Still-Face Experiment

The same experiments with Dads can be found here:

The best Ted Talks about Adverse Childhood Experiences include this:
How Childhood Trauma affects Health
on ACEs with Dr. Nadine Burke Harris

Last Call for Program Narratives:
If you have not yet sent your program narrative to Kelly O’Rourke or me, please do so immediately. These are stories and accounts of how your program works, what is new with your policies or procedures, new networking your program has linked into, or other innovative or unique news from the last year. How are you connecting families? How are you serving your community? One or two paragraphs is sufficient, and photos are welcome.
Tools for Parents: Motivating Children to do Well in School
By Elena Simonsen

Introduction
Motivation is an important component of academic success. It is related to positive outcomes such as lower school drop-out rates, higher scores on tests, and generally having positive feelings about school. Unfortunately, not all children are highly motivated to do well in school. However, there are many ways that their motivation to do well in school can be increased.
Objectives
This EPress serves to provide information about:
• Creating a positive environment in which children can complete their homework
• Teaching children organizational skills that they can practice
• Helping to increase children’s motivation to be successful in school
Creating a Positive Learning Environment at Home
Homework is an important component of the learning process. Homework assignments help children to gain a better understanding of the topics covered in class while also teaching them essential life skills like time management and responsibility. Homework provides a great opportunity to get involved in what the child is doing at school. The following suggestions can be made to parents for the purpose of creating a home environment that is conducive to learning:
• Designate a study space. Having a specific spot for the child to just do school work may help him or her to be more focused.
• Limit distractions. This includes television, vocal music, and phones. Select a space where it’s unlikely for the child to be interrupted by other family members.
• Adequately illuminate the study space. Make sure there is enough light in the study area, and enough space for the child to comfortably complete his or her work.
• Provide necessary supplies. Make sure the child has all the supplies he or she may need to complete homework. These items may include pencils, paper, pens, tape, glue, and a calculator.

Organizational Skills to Teach Children
Children who learn to be organized can stay on top of their assignments and reduce their anxiety. The following organizational skills can be suggested to parents:
• Making a schedule. Giving the child a calendar or planner will be helpful in doing this. It’s a good idea to create both daily and weekly schedules. At the start of each week, the child can write out all of the deadlines he or she has coming up, such as tests or projects. This way they can prioritize each day, and decide what he or she needs to get done that day, and what order to do things in.
• Set goals. Setting daily and weekly goals for children is a good way to motivate them to complete assignments successfully and independently. Some tips for goal-setting with a child include:
o Set goals that the child can attain. Make sure that the goals aren’t too difficult for the child to reach. Achieving goals will make the child feel good about him or herself, and will motivate the child to continue working towards bigger goals.
o Set specific goals. For example, a child struggling with math may set a goal to correctly complete ten algebra problems each night for five nights.
o Reward the child when he or she reaches a goal. Praise should be provided immediately. Provide smaller rewards, such as 30 minutes of television, for completing daily goals. Larger rewards, such as a trip to the mall, may be agreed upon for achieving weekly goals.
• Break it down. Larger assignments may be broken down into smaller, more manageable pieces. This will make writing papers, studying for tests, and doing projects seem less intimidating.
• Balance. While doing well in school is very important, children should be engaging in other activities as well. They should also be spending time with friends and engaging in extra-curricular activities such as clubs, sports, and volunteer work.
Tips to Increase Motivation
While no one can make a child want to do well in school, there are several things that can be done to help foster motivation:
• Be a positive role model. Show the child that you’re interested in learning. Let the child see you reading a book. Talk to the child about history or politics. Ask the child questions about science or art.
• Praise the child often. Let the child know that you think he or she is doing a great job, and that you are proud of him or her. Repeated praise can help the child to feel more positively about school as well as boost his or her self-esteem.
• Be supportive. Create a positive environment around school and learning. Let the child know that you are there for him or her and want to help in whatever way you can.
• Be kind, but firm. Try to avoid criticizing or punishing the child. Instead, work with the child to create expectations for his or her school performance. Encourage achievement by praising the child for meeting these expectations.
• Maintain a positive relationship with the child. This can be done by following some of the tips listed above.
Case Scenario
Alex’s parents are worried about his grades. Lately, Alex has been spending a lot of time playing video games or hanging out at a friend’s house. When his parents ask him about homework, Alex claims he doesn’t have any. Alex’s parents met with his teacher to voice their concerns. Alex’s teacher told them that Alex wasn’t doing his homework assignments, and suggested that Alex’s parents sit down with Alex and set some goals and make a homework schedule. That night, Alex’s parents sat him down and told him that they were worried about his grades, and let him know that they were there to help. Alex set a goal of completing at least 3 out of his 4 weekly math assignments. His parents gave him a planner, and he was able to write down all of his weekly assignments in it. Every day after school, Alex sat at his own desk in the office for an hour and worked on his homework. When Alex completed his goal, his parents gave him some money to put towards the new video game Alex wanted to buy. Slowly, Alex’s motivation and his grades began to improve.
Conclusion
Many children have a hard time staying on track with their school work. Motivation is a key component of school success. There are many ways that caregivers can help foster a child’s motivation to do well in school. Monitors may start a conversation with parents and include some of the suggestions listed in this article to help their child find motivation and success.

References
Center for Effective Parenting (n.d.). Homework: How to Motivate Your Child. Retrieved from http://www.parenting-ed.org/handouts/Homework%20Handout%20.pdf
Deci, E. (1991). Motivation and Education: The Self-Determination Perspective. Educational Psychologist, 26, 325-346. doi: 10.1080/00461520.1991.9653137
Pincus, D. (n.d.). 10 Ways to Motivate Your Child to Do Better in School. Retrieved from https://www.empoweringparents.com/article/10-ways-to-motivate-your-child-to-do-better-in-school/

Impacts of Healthy Eating
By Eliot Kemper

Introduction
Since the 1970’s, the number of fast food restaurants has doubled! Empty calories from added sugars and solid fats make up 40% of calories for 2-18 year olds, largely from soda, desserts, and pizza.

Objectives
This EPress will explore:
• Parent’s roles in establishing and modeling healthy eating habits for their children
• Recent research findings on child nutrition
• Common nutrient deficiencies and their symptoms
• Resources for parents
Food and health go hand in hand

Why this is important
Establishing healthy eating habits during childhood is important because those habits, and their health outcomes, have been shown to carry on into adulthood. This means that the poor eating habits which are associated with heart disease, diabetes, cancer, osteoporosis, and other health consequences can be avoided by establishing positive relationships with food early on.

A parent’s role and household habits
Heathy eating is one important aspect of a child’s wellbeing, and any dietary or malnourishment concerns should be addressed as soon as possible. Monitors may encourage parents to discuss and model healthy eating in their homes, as well as educating themselves on nutritional deficiencies that may be affecting their children. Adults, siblings, and peers provide children and teens direct and indirect examples for healthy eating behaviors, so the first step in getting a child to eat well can often be found in making sure the rest of the household does too.
Positive reinforcement for healthy eating decisions, consistent and appropriate limit setting in feeding issues, and emotional encouragement have all been shown to be effective tools for parents to help their children’s eating habits, and should be encouraged among parents.

Recent research on child nutrition
Nearly all children 2 to 11 years old have a poor to below-ideal diet. [1]

Most parents of 1-6 year olds know basics about healthy eating, but aren’t aware that body image can be psychosocially important before adolescence. Most parents also express a desire for more information about how not to encourage negative body image while still promoting healthy eating. [5]
54.5% of US kids aged 6 to 19 don’t drink enough water, especially among boys and non-Hispanic Blacks. This can be remedied by drinking one extra cup of water per day. [2]

What are some of common issues to keep in mind?
 Only 1 in 5 kids eat the recommended five daily servings of fruits and vegetables, while 84% eat too much fat.
 Only 2% of kids meet all of the national food guide recommendations, and 16% don’t meet any.
 Across the board, most kids eat too few fruits, vegetables, and whole grains, but consume too much fat, cholesterol, sodium, and added sugars.
Nutrient to know % of kids who don’t get enough Symptoms Ways to get more Who’s at extra risk
Iron Up to 16% are seriously deficient. Anemia (Paleness, tiredness, irritability, more frequent infections) Apricots, poultry, red meats, dhal, hummus, chickpeas, fish, dried beans, lentils, soybeans, eggs, oatmeal, peanut butter, prune juice, raisins, prunes, spinach, kale and other greens. Overweight children, those under two years of age, teenage girls
Vitamin D 81-98% don’t meet ideal levels. 61% have insufficient levels.
9% are seriously deficient. Tingling or ‘pins and needles’ sensation around the mouth and lips, or in the ends of the hands and feet. Knee pain. Strong and lasting muscle contractions. Stunted growth. Rickets. Seizures. Eventually, serious heart issues. Getting out in the sunlight more. Also, oily fish, orange juice, fortified milk, egg yolk, mushrooms, and some yogurts, and supplements. Overweight children, those with darker skin, those with chronic illnesses.
Vitamin E Over 80% don’t meet ideal levels, although symptoms are rare unless seriously deficient. Peripheral neuropathy, ataxia, skeletal myopathy, retinopathy, and impairment of the immune response Wheat germ oil, nuts and seeds, dark leafy vegetables, tomatoes. Teens and older, newborn infants
Calcium 31% of 4-8 year olds,
70-92% of 9-18 year olds don’t meet ideal levels. Few short term symptoms unless severe Few short term effects. In the long term, hypocalcemia (numbness, cramps, convulsions, lethargy, abnormal heart rhythms, poor appetite), rickets, bone loss/weakening, and osteoporosis. Raised cancer and heart disease risk Yogurt, milk based products, tofu, kale, broccoli, corn tortillas, sardines, fortified orange juice, turnips Lactose intolerant people, vegetarians, vegans,
Vitamin C 43% of children above 14 don’t meet ideal levels, and 6% of children above 12 are deficient Scurvy (inflammation, fatigue, limping, gum bleeding, swollen extremities) if severe. Long term increased cancer risk and reduced overall health if deficient. Citrus, tomatoes, potatoes, broccoli, strawberries, cabbage, spinach Cigarette smokers

Resources for parents
http://www.letsmove.gov/

http://www.pbs.org/parents/food-and-fitness/eat-smart/encourage-kids-to-eat-healthy-food/
https://secure02.kidshealth.org/parent/nutrition_center/#khsc
https://medlineplus.gov/childnutrition.html
http://www.heart.org/HEARTORG/HealthyLiving/HealthyKids/HowtoMakeaHealthyHome/Healthy-Foods-Under-1-Per-Serving_UCM_303809_Article.jsp

References
http://www.fitness.gov/resource-center/facts-and-statistics/
U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 – 2020 Dietary Guidelines for Americans. 8th Edition. December 2015. Available at http://health.gov/dietaryguidelines/2015/guidelines/.
https://medlineplus.gov/ency/article/007134.htm
http://ocw.tufts.edu/data/47/531553.pdf
http://www.ewg.org/research/how-much-is-too-much/appendix-b-vitamin-and-mineral-deficiencies-us
https://www.nap.edu/read/11899/chapter/4#42

New Training Manual for Florida’s Supervised Visitation Programs
THE IMPACT OF CHILD PHYSICAL ABUSE ON SUPERVISED VISITATION
Families may be referred to supervised visitation programs for many reasons. Children may have been removed from their homes because they have been abused, or they might enter into supervised visitation for a different reason and program staff may suspect abuse. As such, it is imperative that visitation monitors be adequately educated in the dynamics of child abuse should they be working with a family where abuse has, or is suspected to have, occurred.
Child abuse can be physical or sexual in nature, and may manifest in many different ways. This chapter aims to provide visitation monitors with the knowledge base and skills to both identify, and appropriately respond to child abuse in visitation services. Child abuse is complex, and will often result in more than just physical injuries. There are many other mental, emotional, and behavioral consequences surrounding abuse, which will impact children in different ways.
Additionally, it is important for visitation monitors to understand the complex factors that influence an adult to become abusive toward a child. Parents who have abused their children may be unable to cope effectively with their own prior trauma or other stressors. It is important for a visitation provider to remain sensitive to the complex nature of abuse, and to behave professionally during the provision of services.
Upon completion of this chapter, a visit monitor will be able to:
• Define physical abuse;
• Identify different types of child physical abuse;
• Understand and explain the impact abuse has on childhood victims;
• Identify common injuries associated with abuse;
• Reference Florida Statute definitions of abuse;
• Identify different risk factors for child abuse;
• Identify and encourage the development of protective factors within families;
• Anticipate possible reactions to visitation;
• Adequately prepare for, monitor, and follow-up on visitation where child abuse is present or suspected;
• Report child abuse

• Child abuse occurs at every socioeconomic level, across ethnic and cultural lines, within all religions, and at all levels of parental education.
• About 30% of abused and neglected children will later abuse their own children.
• As many as 14% of men and 36% of women in prison were abused as children.
• As many as two-thirds of people in treatment for drug abuse reported being abused or neglected as children.
• According to the 2013 Child Maltreatment report, in all cases of substantiated child maltreatment, 18% were victims of physical abuse.

 

Physical child abuse is an adult’s physical act of aggression directed at a child that causes injury, even if the adult didn’t intend to injure the child. Acts of physical abuse may include:
• Striking a child with the hand, fist, or
foot or with an object
• Burning the child with a hot object
• Shaking, pushing, or throwing a child
• Pinching or biting the child
• Pulling a child’s hair
• Cutting off a child’s breathing
Other Kinds of Child Physical Abuse:
• Shaken Baby Syndrome involves a frustrated caregiver shaking a baby, in an attempt to make the baby stop crying. Since the baby’s neck muscles cannot properly support its head, the baby’s brain bounces around inside its skull causing brain damage which often results in severe neurological problems and even death.

• Munchausen’s Syndrome by Proxy involves a parent intentionally causing the child to become ill, rushing them to the doctor and convincing them that the child is sick. This behavior on the part of the parent is likely motivated by a desire for attention and sympathy.

• Corporal Punishment- an antiquated form of disciplinary action for children, which involves the use of physical force with the intent of inflicting bodily pain, without injury, for the purpose of correction or control of a child.

Physical Impact
As illustrated above, there are many physical consequences of abuse. While the severity of injuries can vary greatly, the consequences of abuse abound. Below are some other documented consequences of physical abuse on children.
• Abusive Head Trauma: Head trauma resulting from shaking and blunt impact to the head is the most common cause of traumatic death for infants. Although related injuries may not be immediately noticeable, this kind of injury impedes healthy brain development in children.
• Impaired Brain Development: Child abuse and neglect have been shown to significantly impact brain development. Some regions fail to form properly causing long-term consequences for cognitive, language, and academic abilities, and have also been tied to mental health disorders.
• Poor Physical Health: Child abuse also affects long-term physical health by increasing the likelihood of chronic disease such as cardiovascular disease, lung and liver disease, hypertension, diabetes, asthma and obesity. Specifically, physical abuse has been shown to increase the risk of diabetes and malnutrition.

Psychological Impact
Apart from the psychical impacts of child abuse, there are also many psychological consequences that arise as a result of childhood trauma. These can manifest as behaviors like isolation, fear, and the inability to trust others. If left unattended these behaviors have the potential to have long-term consequences on a person’s mental health.
• Difficulties during infancy: When infants and young children enter out-of-home care due to abuse or neglect, the trauma of a primary caregiver change negatively affects their attachments. As a result, nearly half of infants in foster care who have experienced abuse exhibit some kind of cognitive delay and lower IQ scores, language difficulties, and neonatal challenges, when compared with children who have not been abused or neglected.

• Poor mental and emotional health: Childhood abuse is a risk factor for borderline personality disorder, depression, anxiety, and other psychiatric disorders. It also negatively impacts the development of emotional regulation which can carry on through adolescence and adulthood.

• Cognitive Difficulties: Child victims of abuse are also at risk for severe developmental and cognitive issues, including grade repetition.

Behavioral Impact
Although not all childhood victims of abuse manifest behavioral issues, they are certainly more likely to than their non-victimized counterparts to suffer negative consequences. They may experience any or all of the following:
• Difficulties during adolescence: Data has shown that children who have been abused often repeat grade levels in school, and engage in substance abuse, delinquency, and truancy. They are also more likely than their peers to engage in sexual risk-taking, which also increases their chances of pregnancy and contracting sexually transmitted diseases.

• Juvenile delinquency and adult criminality: Several studies have also documented a correlation between child abuse and future delinquency.

• Alcohol and other drug abuse: Research has also shown that victims of child abuse have an increased likelihood of abusing alcohol, smoking cigarettes, or taking illicit drugs during their lifetime.

• Abusive behavior: Studies have also shown that child victims of abuse often become abusive parents to their own children.
Societal Impact
• Direct Costs: According to a CDC study, the lifetime cost of child maltreatment and related fatalities over the course of a year totals $124 billion. By comparison, prevention programs have proven to be cost effective, providing a favorable cost/benefit ration at $47 benefits to society for every $1 spent on program costs.

• Indirect Costs: These long-term societal consequences of child abuse and neglect are varied and include costs associated with increased use of health care, criminal activity, mental illness, substance abuse, and domestic violence.

The co-occurring signs and symptoms of physical abuse can be overt, like a physical injury, or more insidious, like a change in behavior. As such, it is important to be vigilant of the physical signs of abuse as well as the behavioral and psychological signs that may not be obvious to the untrained eye. The table below outlines some physical and behavioral signs of abuse.

Signs and Symptoms of Physical Abuse

Physical
These visible injuries may or may not be visible to the monitor and can be covered by clothing. • Unexplained or frequent burns, bruises or other injuries
• Black eyes
• Bruises in areas of the body not typically injured by accidental or normal childhood activities
• Faded bruises or healing injuries following absence from school
• Human bite marks
• Burns on the arms, legs, or areas covered by clothing
• Cigarette burns
• Bruises shaped like objects, such as a hand or belt buckle
• Marks around the wrist or ankles, indicating someone may have tied the child up
• Difficulty walking/sitting
• Delays in normal physical development
• Obvious need for medical care/personal hygiene

Behavioral
A child’s behavior may suggest a history of abuse, especially in the presence of the abuser. • Depression/attempted suicide
• Withdrawal from friends and social activities
• Unbelievable or inconsistent explanations of injuries
• Unusual shyness
• Avoidance of eye contact with adults or older kids
• Apparent fear of caretakers – parent(s)/caretaker(s)
• Anti-social behavior in older kids such as truancy, drug abuse, or running away from home
• Child seems overly watchful, on edge, as if anticipating something bad is going to happen
• Expresses a reluctance to go home
• Extreme changes in behavior/temperament
• Delays in emotional development
• Lack of emotional attachment to parent

Parental or Other Caregiver Behavior
The behavior of a parent or another caregiver may also indicate the presence of abuse. • Demeaning attitudes towards the child
• Expresses the child is wholly bad and burdensome
• Expresses little concern for the child and his or her life, such as their performance in school
• Rarely displays physical affection toward the child
• Thinks of the relationship as completely negative
• Verbalized dislike for the child
Types of Injuries

There are many different types of injuries seen in children who have been physically abused. The table below, although not exhaustive, provides a list of common injuries resulting from physical abuse and their likely causes.

Table E: Types and Examples of Physical Abuse
Injury Definition Caused By
Bruises Injuries resulting from bleeding within the skin, skin is discolored but not broken Some sort of blunt trauma such as hitting or punching
Cuts, punctures, or bites A cut or break in the skin Result from injury caused by a sharp object, or teeth
Burns/scalds Tissue injury resulting from exposure to extreme heat or chemicals Deliberately exposing a child to extreme temperatures or chemicals
Dislocation of bones Displacement of a bone from its joint May be caused by putting unnatural force on a joint, such as pulling or dragging a child
Fractures Broken bone
May be: Simple, Compound, Complicated, or spiral May be caused by twisting or pulling an arm or leg, or by shaking or striking a child
Internal Injuries Injury to the internal organs Severe blow to the abdomen with a body part or object
Head Injuries Broken bone in the skull, or injury to the nervous system or brain. Can be caused by hitting or shaking a baby. Shaken-baby syndrome occurs when brain damage is caused by violently shaking a child
Asphyxiation (Suffocation) Choking, smothering, or drowning, which interfere with a child’s oxygen intake Strangling a child with hands or object, or placing some object over a child’s nose or mouth
Deadly Weapon The use of a deadly weapon in the process of abuse can produce any of the injuries above Use of a gun or knife to punish or illicit cooperation from a child. Can be an actual injury or threatened one
Beating and/or excessive corporal punishment Striking a child in a manner that results in temporary or permanent disfigurement or injury. Corporal punishment that results in injury

Bruises
Bruises are often the first sign that a child has been hurt, and depending on the location, may be an indication of physical abuse. They can present in many different ways, depending on the nature of the injury that caused it. Outlined below are some common kinds of bruises that are consistent with child abuse.

Strangulation: These kinds of bruises generally result from something being wrapped around a child’s neck, and may present in a semi-circle shape. If the bruise appears to taper off to one side, it may indicate the use of a rope or similar object. If a strangulation bruise is suspected, the child’s eyes may show red spots, which is an indication of lack of oxygen due to strangulation.

Fixed Object Bruises: These kinds of bruises are often caused by the use of blunt objects such as paddles, coat hangers, etc. These may resemble the shape of specific objects.

Bruises Caused by Aggressor’s Body: These bruises generally occur when the abuser uses their bare hands or other body parts to inflict harm. They may appear around the neck, wrist, ankles, or shoulders in the shape of an open hand or fist.

In Infants and Children: It is uncommon for infants to have naturally occurring bruises before they are able to crawl or walk. It is also uncommon for bruises to appear on soft areas, such as the stomach or buttocks. If a visitation monitor notices bruises in these locations on infants, this should be considered a red flag and be investigated further.

If an unnatural or unusual bruise is identified, a monitor should ask the parent or child to explain where the bruise came from. Stories that are inconsistent, unbelievable, contradictory, or have timelines that do not match the age of the bruise, are all indications of abuse. Visitation monitors should utilize appropriate avenues to report reasonable suspicions.

Identifying Signs of Physical Abuse on Darker Skin
Bruising is one of the earliest and most identifiable signs of physical abuse. However, bruises can be difficult to identify on darker skin, due to the lack of contrast between the color of the bruise and natural skin tone. In general, they appear fainter and are often less apparent compared to bruises on those with lighter skin tones.
Identifying Ages of Bruises on Dark Skin
Age Presentation
0-2 Days Typically red/pinkish
2-4 Days Purple, blue, or black
5-10 Days Yellow or green
10-14 Days Light brown or faint yellow
14+ Days Bruise tends to fade away
When attempting to identify the age of a bruise on dark skin, refer to the following table.
Polyvictimization, Development, and Behavior

Current research has discovered that most children who experience one type of abuse often experience others, which is known as polyvictimization.

A recent national report showed that polyvictimized children are at an increased risk for losing the fundamental capacities necessary for normal development, successful learning, and a productive adulthood. Youth who have been victimized in multiple ways also show an increased risk of aggressive and destructive behaviors when compared to their non-victimized counterparts.

Current research has also uncovered the effects of abuse on children’s brains. According to one study, physically abused children showed alterations in the orbitofrontal volume when compared with typically developing children. Volume shrinkage in this particular part of the brain has been related to measures of family stress. Among physically abused children, those showing poorer academic performance and family functioning (family stress) also exhibited less volume in this region of the brain. This study, alongside a substantial body of scientific research, has demonstrated the effects of stressful environments on the developing human brain and associated behaviors (Davidson & McEwen, 2012).

A groundbreaking study called the Adverse Childhood Experiences (ACE) study compiled a multitude of cases to examine the correlation between childhood maltreatment and adult health and well-being.

Reactions to abuse can be as varied as the many manifestations of abuse itself. As such, it is important that visitation monitors be adequately prepared for any situation that might arise during visitation. He/she should be aware of their own emotional response to the disclosure of or presentations of abuse and be able to intervene or redirect as appropriate.
Children
Monitors should pay close attention to children’s behavior during visitation, as it could be an indicator of abuse. Although not all children will react in the same way, their behaviors can run the gamut from quiet and aloof, to loud and emotional. They may also exhibit fear of their parent or caretaker. Monitors should also be vigilant of any triggers that may make memories of abuse arise in children during a visitation. Triggers can also take on many forms, such as being in a similar setting where the abuse occurred, or the scent of cologne or other product used by the abuser. The fact that a child does not appear fearful could simply mean that he or she feels safe in the controlled environment of supervised visitation.
Parents
Much like children, parents who have abused their children can display a wide range of behaviors at visits. For instance, they may behave detached, depressed, angry, or even guilty. Although it is unlikely that a parent would blatantly physically abuse their child during visitation, there could be several other indicators of abuse. For instance, they may interact with the child in unusual ways, such as using coded messages to communicate, or physical contact that seems to trigger the child negatively and remind them of the abuse. Monitors should pay close attention to any and all possible signs of abuse, document them and take appropriate action.
Foster Parent/Family Members
Foster parents or family members who have temporary custody of children due to abuse may be understandably leery of visitation. They may express anxiety or fear about the potential harm of the child during or as a result of visitation with an abusive parent. Monitors should listen to their concerns and take them into consideration, while reassuring them that the child’s safety is their priority and they will be vigilant to assure that the child is safe.
Staff Members
As mentioned earlier, visitation monitors should be keenly aware of their own feelings and reactions to the disclosure of or suspicion of abuse. They can have a range of emotional reactions, but should be able to manage those emotions and be prepared to respond appropriately and professionally. They may be the first to learn about past or ongoing abuse, so their response is of the utmost importance.

Visitation monitors should be familiar with all of the identified risk and protective factors present in families in order to be effective in their duties and identify, intervene, and report abuse.

Risk Factors
Many different factors may increase a family’s risk for child abuse and maltreatment. Having knowledge about these factors and being able to identify them is invaluable to the prevention of child abuse. Several identifiable risk factors are outlined in the table below.

Protective Factors
Much like risk factors, there are six identified protective factors in families and communities which reduce the likelihood that violence and/or abuse will occur. They are:
1. Nurturing and attachment
2. Knowledge of child developmental stages
3. Parental resilience
4. Supportive social connections
5. Access to concrete community support
6. Social and emotional competence of children

Below is a table which illustrates identified risk/protective factors for children, family, and society. Any combination could either lead to more risk or protection from abuse.

Risk and Protective Factors of Child Abuse
Risk Factors Protective Factors
Child • Developmental or physical disability
• Under the age of 5
• Special needs that increase caregiver burden
• Mental illness
• Chronic physical health problems
• Temperament: slow or difficult to warm up to adults
• Childhood trauma • Age-appropriate development
• Good health
• Good peer relationships
• Personality factors such as:
Easy temperament,
Positive disposition,
Active coping system,
Positive self-esteem,
Good social skills,
Internal locus of control,
Balance between help- seeking and autonomy.

Family As seen in the abusive parent
• A history of being abused
• Poor childhood experiences
• Insecure attachment
• Physical or mental illness
• Family crisis or stress
• Financial stress or unemployment
• Social or extended family isolation
• Poor understanding of child development
• Lack of parenting skills
• Alcoholism or substance abuse
• Parent’s immaturity
• Large number of dependent children
• Personality factors, such as: external locus of control,
poor impulse control, depression/anxiety,
low tolerance for frustration, feelings of insecurity,
lack of trust

• Supportive family environments
• Nurturing parenting skills
• Household rule/structure and parental monitoring
• Stable family relationships
• Parental employment
• Adequate housing
• Access to health care and social services
• Parents model healthy coping skills
• Parent’s level of education
Societal/
Environmental • Low socioeconomic status
• Lack of access to adequate medical care, health insurance, child care, or social services
• Parental unemployment or homelessness
• Exposure to racism/discrimination
• Lack of quality education
• Community violence • Access to healthcare
• Consistent parental employment
• Family religious participation
• Access to quality education
• Caring adults outside the family who serve as role models or mentors

Strategies to Build Protective Factors

The table below provides suggestions for visitation monitors to employ with visiting or custodial parents, in order to develop protective factors and prevent child abuse.

Protective Factor
Action
Nurturing and Attachment Inform parent about the importance of being present in the child’s life and encourage them to become more involved
Remind parent to show affection when leaving and greeting his or her child at visitation
Encourage parent to listen to his or her child when talking about visits etc.
Provide parent with Economic-Friendly Activities for Families
Provide parent with Top 10 Strategies to Facilitate Child Communication
Discuss how parent can praise his or her child and provide tips from Catching the Good and Praising Your Child Handout
Knowledge of Child’s Developmental Stages Provide parent with information on child’s age group and development
Discuss age-appropriate consequences and punishments for children
Inform parent of age-appropriate activities in the community
Remind parent of ways that he or she can support child in new activities
Provide parent with the Every Child is Smart Handout
Provide parent with the Family Development Guide

Parental Resilience Discuss parts of life that cause stress and recommend resources to help reduce that stress (low-cost child care services)
Suggest positive coping skills and activities
Inform parent of any free resources for physical health or medical services (yoga at the community center, free physicals at the clinic)
Remind parent to practice self-care and coping skills
Acknowledge when he or she makes it through a challenging time
Remind parent that he or she is strong and resilient, provide parent with 10 Things Parents Do Great

Supportive Social Connections Check-in with parent and discuss their personal barriers to receiving support
Educate parent about local support groups and programs
Encourage parent to meet new people and refer him or her to a community event
Help parent identify friends, neighbors, or acquaintances in his or her life who are supportive in times of need
Look for barriers to social involvement for the parent (child care, transportation, or self-confidence)

Access to Concrete
Community Supports Discuss with parent what his or her specific needs are
Provide parent with appropriate referrals to agencies that meet those needs
Inform parent about free resources in the community (arts and crafts night, movie in the park, free health screenings, etc.)
Where necessary, help parent in accessing services (referral form, signatures, etc.)
Inform parent about any new resources that may be time sensitive (Tax-free week, free vaccinations, etc.)
Follow up with parent concerning their access to supports and where they may still need assistance
Social and Emotional Competence Discuss how the parent approaches talking about emotions with their child
Ask parent how he or she deals with emotions such as anger, sadness, or frustration
Ask parent about his or her feelings and child’s feelings
Provide parent with Role Playing Emotions with Children Handout
Follow-up with parent on emotional intelligence

Missing the Signs of Child Abuse
At every meeting with children and caregivers, monitors should be alert to the presence of any of following, as they may be warning signs that child abuse might be present. Be sure to document and report any substantial concerns.

Signs of Physical Abuse
• The child verbally expresses that he or she has been abused.
• Frequent injuries that are attributed to the child being clumsy or accident- prone
• Inconsistency between stories from children and parents, such as:
o Injuries that do not fit the story provided
o Conflicting explanations between the adult and child’s story
o Unbelievable events given the child’s developmental stage
• Habitual absence from school without legitimate reason(s)
• Long sleeve shirts or jackets being worn when it is hot outside
• Awkward movements or difficulty walking, consistent with healing injuries
• Cuts, burns, sprains, or injuries that have not been explained adequately