Mindful Continuing Education

Eliminating Child Abuse Fatalities

Executive Summary: Our Promise to Children

1. Although no one knows the exact number, four to eight children in the United States die every day from abuse or neglect at the hands of their parents or caretakers, and there has been little progress in preventing these tragic deaths.

A. True B. False

2. The Commission to Eliminate Child Abuse and Neglect Fatalities (CECANF) has developed a national strategy to identify and support children at highest risk of abuse or neglect fatality, which includes each of the interrelated core components EXCEPT:

A. Leadership and accountability B. Reframing social norms C. Decisions grounded in better data and research D. Multidisciplinary support for families

Introduction- Child Abuse and Neglect Fatalities Affect Us All

3. In addition to the emotional costs of child abuse and neglect, a study from the Centers for Disease Control and Prevention (CDC) found that the total lifetime cost for just one year of confirmed cases of child maltreatment is approximately $62 billion.

A. True B. False

A Time for Action

4. Even with the federal government’s implementation of recommendations to prevent child abuse and neglect fatalities, data submitted to the National Child Abuse and Neglect Data System (NCANDS) between 2001 and 2010 show a slight increase in fatalities over the decade.

A. True B. False

Chapter 1: Confronting the Tragedy of Child Abuse and Neglect Fatalities-Data

5. In the United States, there is currently no standard, mandated reporting system for child abuse or neglect deaths in this country, and definitions, investigative procedures, and reporting requirements vary from state to state.

A. True B. False

The Broader Picture of Safety

6. Which of the following is NOT a correct statement about foster care?

A. Growing up in foster care can have dire consequences, such as uncompleted education or substance abuse B. Removing children from their families and homes is almost always a traumatic experience, even when it is necessary C. Foster care in and of itself is a guarantee of relief and safety D. Foster care placement is used disproportionately in African American families

Our Current Approach to Protecting Children Is Not Enough

7. Although interventions such as long-term group care and nonspecific psychotherapy tend to be high-cost, they have been considered very effective in addressing the needs of families most at risk of fatalities.

A. True B. False

Three Interrelated Components for Success

8. One recommendation for success is the sharing of real-time dataii and the use of ________ analytics to identify children most at risk of fatalities and factors related to high risk.

A. Prescriptive B. Predictive C. Advanced D. Reactive

We Must Act to Save Children’s Lives Now: Highlighted Recommendations

9. In order to begin to save lives immediately, experts suggest the spearheading of a special initiative to support state and local entities engaged in protecting children, such as law enforcement and CPS, in sharing real-time electronic information on children and families.

A. True B. False

10. Another recommendation is flexible funding in existing entitlement programs to provide critical intervention services in substance abuse, __________, and early infant home visiting services to support mitigation of danger within families at risk for child maltreatment fatalities.

A. Mental health B. Response to Intervention (RTI) C. Nutrition D. Physical health

Section 1-Populations in Need of Special Attention

11. The CECANF focused on three groups who need special attention: American Indian/Alaska native children, African American children, and children known to the CPS system today who are at high risk of fatality.

A. True B. False

Hillsborough County, Florida/Using Data to Improve Practice and Keep Children Safe

12. In Hillsborough County, Florida, leaders used real-time data to identify a list of high-risk cases and they found that families in which a fatality or serious injury occurred shared multiple risk factors, including young parents, mental health problems, and:

A. Intergenerational abuse B. Domestic violence C. Substance abuse D. All of the above

Data Analytics Lead to Action

13. The Eckerd Rapid Safety Feedback (ERSF) uses a combination of data and practice change focused on prevention of child fatalities, and promotes the transfer of new skills learned by case managers and supervisors in one case to others, which is referred to as allocating.

A. True B. False

Chapter 2: Saving Children’s Lives Today and Into the Future

14. The Commission noted that in some abuse and neglect cases, even though local CPS agencies had been alerted to the risks facing children, these children weren’t able to be saved. All of the following were possible reasons for this EXCEPT:

A. The agency had not consistently monitored their well-being B. The agency had not taken any action C. The agency had not taken adequate protective action D. Other mandatory reporters who had seen the child did not alert CPS about possible abuse or neglect

What We Learned: A Report of Maltreatment Indicates Increased Risk

15. Although it is known that many children who die from abuse or neglect are not known to CPS before their death, a previous report to CPS is the single strongest predictor of later death from injury.

A. True B. False

Learning More About What Contributes to Child Fatalities

16. Circumstances that that might indicate a higher risk for a child maltreatment fatality may include characteristics of that child such as age and health status, parent and family characteristics, and:

A. Detachment B. Environmental norms C. Neighborhoods D. None of the above

17. The Commission recommends that the U.S. Department of Health and Human Services (HHS) should provide national standards, proposed methodology, and technical assistance to help states analyze their data from the previous five years.

A. True B. False

18. One group of Commissioners recommends an increase in funding, but leaves the responsibility to individual state legislatures to identify the exact amount of funding needed to carry out activities in this goal, and to determine sources of that funding.

A. True B. False

Chapter 3 Addressing the Needs of American Indian/Alaska Native Children

19. Which of the following is true about American Indian and Alaska native (AI/AN) child maltreatment fatalities?

A. There is an abundance of data on how many AI/AN children die from abuse or neglect B. Jurisdictional issues affecting AI/AN tribes tend to be similar to those of other underrepresented populations C. Most data comes from the individual tribes D. Abuse and neglect fatalities are not recorded in any systematic way.

20. Which is NOT a correct statement?

A. Tribes are not eligible for Child Abuse Prevention and Treatment Act (CAPTA) funds B. The federal government collects pertinent data from the tribes C. In some states, federal agencies such as the Bureau of Indian Affairs or the FBI handle homicides, rather than tribal officials D. The death of a shaken AI/AN baby who dies on a reservation where a federal agency handles homicides may be recorded as a generic death, rather than a child death or child abuse death

21. Regarding jurisdictional confusion, the Commission noted a lack of leadership and authority at the state and county level to work with tribes on the issue of child abuse and neglect fatalities

A. True B. False

22. Although there are multiple jurisdictional challenges with a child abuse and neglect fatality of an AI/AN child, experts noted the ability of the clan and family structures within tribes to maintain their sovereign tribal communities by exhibiting:

A. Loyalty B. Perseverance C. Resiliency D. Respect

23. The Commission recommends that tribes should be able to access case management, case monitoring, and supports necessary to maintain children within the home, beyond the standard work day hours of 9:00 a.m. and 5:00 p.m.

A. True B. False

Chapter 4: Reducing Child Abuse and Neglect in Disproportionately Affected Communities- What We Learned

24. Which is a correct statement about child welfare and race?

A. African American children are more likely than white children to be reported to CPS as possible victims of abuse or neglect, more likely to be investigated, and more likely to be removed from their families B. African American families are less likely to receive in-home services or to be reunified than are white families C. African American families are less likely to receive in-home services or to be reunified than are white families D. All of the above

25. The National Incidence Study-4 (NIS-4) found that African American children were maltreated at a higher rate than white children in all categories.

A. True B. False

Addressing Racial Disproportionality in Child Welfare

26. Sacramento County’s work on addressing child abuse fatalities of African American children is an example of using a ________ strategy and mobilizing a broad range of stakeholders to address the issue.

A. Place-based B. Broad-based C. Research-based D. Strengths-based

Recommendations

27. All of the following are recommendations from the Commission about the use of Intact Family Courts in communities with disproportionate numbers of African American child fatalities EXCEPT:

A. There would be a voluntary process for families B. Initial intake would include a physical examination for every child C. A judge would appoint a lawyer specializing in family law D. This process would be confidential

28. One of the recommendations for the Executive Branch is to incorporate into the Child and Family Services Reviews (CFSRs) an indicator of the degree to which racial disproportionality is found within the child welfare system at the national level.

A. True B. False

Section II: Components of the Commission’s National Strategy-Wichita, Kansas/Champions for Children

29. The Wichita Coalition for Child Abuse Prevention, which was initiated as a response to eight children’s deaths from abuse or neglect, supports families in preventing abuse by using:

A. A collective impact model B. A skill developmental model C. An asset-building model D. An individual competency model

Chapter 5: Leadership and Accountability

30. The Commission found that accountable leadership at both the federal and state levels for reducing fatalities is often diffuse and occasionally lacking, and it is frequently unclear who is ultimately responsible for reducing child abuse and neglect fatalities.

A. True B. False

31. Which was NOT identified by the Commission concerning the federal government?

A. There was a lack of coordination across agencies and departments as it related to safety and well-being of abused and neglected children B. There has been a failure to commit resources and attention to children’s health and safety across the federal government. C. There is little specific federal leadership or guidance to states and localities on how to prevent or respond to child abuse and neglect fatalities D. The federal government has not released or required agency caseload or workload standards

Challenge 3: Inadequate Federal Oversight

32. What is correct about infant safe haven laws?

A. In Pennsylvania, churches are considered to be safe havens, although this is not the case in other states B. Public awareness about safe havens has increased significantly across all states C. All 50 states have enacted legislation allowing mothers in crisis to safely relinquish their babies to trusted providers D. To insure consistency across state lines, each state follows federal recommendations about immunity from liability for providers, protections for parents, and consequences of relinquishment

RECOMMENDATION 5.2:

33. Congressional legislation to eliminate child abuse and neglect fatalities should allow states local flexibility in designing their plans to best meet the needs of their population and build on resources already in place.

A. True B. False

RECOMMENDATION 5.3:

34. To strengthen accountability measures to protect children from abuse and neglect fatalities, the executive branch should:

A. Direct states to amend their infant safe haven laws to expand the age of protected infants to 18 months B. Provide examples of best practices in state-level policies C. Require training and technical assistance for courts on implementation of applicable federal law D. Ensure that child abuse and neglect fatality information is published on federal public websites

Double Protection for Children/Connecting Law Enforcement and CPS

35. Los Angeles County utilizes the Electronic Suspended Child Abuse Report System (E-SCARS) which allows the Department of Children and Family Services (DCFS) and law enforcement to investigate child abuse reports jointly and focus solely on criminal evidence.

A. True B. False

Chapter 6: Decisions Grounded in Better Data and Research

36. Even where laws permit, local agencies such as law enforcement or substance abuse treatment centers do not always share information with CPS that could potentially save children’s lives.

A. True B. False

37. Determining whether a child’s death is due to abuse or neglect varies across states for several reasons, including each of the following EXCEPT:

A. There are variations in local investigators’ or child death reviewers’ knowledge and expertise in interpreting policy and practice B. Although all death certificates across the U.S. must be completed by a medical examiner, the examiner may not have adequate training on death investigation C. There are differences in states’ reporting practices D. States vary in their definitions of abuse and neglect

38. According to the Commission, states are required to collect and report data on life-threatening injuries in the same way they review and report on child abuse and neglect fatalities.

A. True B. False

Recommendations

39. Military families may be vulnerable to child abuse or neglect because when one spouse is deployed overseas, the other becomes a temporary single parent, re-entry can be difficult when parents return from combat zones, and because of:

A. Limited social support B. Unexpected stressors C. Isolation D. Lack of parenting education

40. One of the Commissions’ recommendations is to expand the standardized set of data elements required to be submitted into the National Child Abuse and Neglect Data System (NCANDS) for all child abuse and neglect fatalities and life-threatening injuries as designated by the operationalized definitions discussed in the report.

A. True B. False

Salt River Pima-Maricopa Indian Community/ Multiple Eyes on the Child- The Family Advocacy Center

41. The Family Advocacy Center, opened in a tribal community as a response to the deaths of two small children, brings together CPS, probation, police, education, prosecution, behavioral health, the fire department, and other agencies as needed, and uses an approach that is child-friendly and:

A. Relationship-focused B. Grounded in harm reduction C. Trauma-informed D. All of the above

Chapter 7: Multidisciplinary Support for Families

42. Media stories often blame child protection agencies alone following a child abuse or neglect fatality, however, parents today are more likely to have drug addictions, mental illnesses, and previous criminal histories, and these issues contribute to fatalities.

A. True B. False

43. Clinicians may be reluctant to report suspected child abuse or neglect because of the clinicians’ negative past experiences with CPS and:

A. Lack of awareness of their duty to report B. Fear of retribution C. Time constraints D. Lack of feedback after making a report

Recommendation-Executive Branch

44. As a means to ensure access to high-quality prevention and earlier intervention services and supports for children and families at risk, the development of educational curricula may be mandated to connect youth to:

A. Their strengths and resiliency B. Their cultural traditions C. The larger community D. Democratic decision-making

Executive Branch and Congress

45. One way to strengthen the ability of CPS agencies to protect children most at risk of harm is for the Executive Branch and Congress to mandate the implementation of service approaches that prioritize keeping AI/AN children within their tribes as a primary alternative to out-of-home placement.

A. True B. False


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