Recognizing and
Responding to Suspicions
of Child Maltreatment
What is Child Abuse and Neglect?
Child abuse can be defined as a non-accidental or substantial risk of injury or pattern of injuries to a child
inflicted or allowed to be inflicted by a parent, guardian, caretaker, or custodian. Child abuse includes:
Physical Abuse – Physical abuse is generally defined as “any non-accidental physical injury to the child” and
can include striking, kicking, burning, or biting the child, or any action that results in a physical impairment of
the child.
• Some signs of possible physical abuse include: unexplained bruises, burns or injuries in various stages of
healing; fear of parent or caregiver; shy, passive or withdrawn; apathy; or unusual wariness of physical contact.
Sexual Abuse – Any sexual behavior imposed on a juvenile including fondling the genital area, masturbation,
oral sex, vaginal or anal penetration of any kind, exhibitionism, child pornography or suggestive behaviors or
comments.
• Some signs of possible sexual abuse include: exhibiting sexual behavior or knowledge of sex that is
not appropriate for the child’s age; reversion to bed-wetting, speech loss or thumb-sucking; sleep
disturbances or nightmares; pain, itching, bruising or bleeding in the genital area; signs of depression or
aggressive behavior.
Emotional Abuse – Expressing attitudes or behaviors toward a child that create serious emotional or
psychological damage as evidenced by the juvenile’s severe anxiety, depression, withdrawal, or aggressive
behavior towards self or others.
• Some signs of possible emotional abuse include: speech disorders or delayed physical and emotional
development; ulcers, asthma or severe allergies; habit disorders like sucking or rocking; low self-esteem;
anti-social or destructive attitude; aggressive, delinquent or attention seeking behavior; depression.
Neglect – Failure of a parent or caregiver to provide food, clothing, shelter, medical care, or supervision that
threatens the child’s health, safety and/or well-being.
• Some signs of possible neglect include: abandonment by parent or caregiver; unattended medical
needs; consistent lack of supervision; consistent hunger, inappropriate dress or poor hygiene; poor social
skills; lice or distended stomach; frequent absences from school; fatigue.
Suspecting Maltreatment
What to do when a child discloses maltreatment
When a child tells you that he/she has been abused, remain calm and let the child know you believe him/
her. Listen carefully to what the child is saying and reassure the child that something is going to be done to
keep him/her safe.
The Law
Any person or institution who has cause to suspect that any juvenile is abused or neglected or has died as
the result of maltreatment, is required to report the case of that juvenile to the DSS in the county where the
juvenile resides or is found. Knowingly or wantonly failing to report or preventing someone else from making
a report could result in a class 1 misdemeanor.
PositiveChildhoodAllianceNC.org | 919.829.8009
Refer a Family to the Department of Social Services (DSS)
If you suspect child abuse or neglect, you can refer the family by calling, writing, or visiting your county DSS – Child
Protective Services (CPS) Unit. County contact information can be found at www.dhhs.state.nc.us/dss/local/.
You can also call the CARE LINE at 1-800-662-7030 to speak with a counselor. It will help if you can provide the
following:
• The name, age, and address of the child
• The name and address of the child’s parent or caregiver
• The child’s condition, including the nature and extent of the injury or abuse
• Any information regarding the presence of weapons, alcohol/drug abuse, or other factors affecting a social
worker’s safety
• Where the child is located at the time the referral is made
Remember:
• You do not need to prove that abuse has taken place; you only need reasonable grounds for suspicion.
• You do not need permission from parents or care givers to make a referral. In fact, you do not even need to
inform them you are making a referral.
• You do not need permission from your workplace to make a referral.
• If you make a referral in good faith, you will receive immunity from possible civil or criminal liability that may
result from your referral. Furthermore, DSS is required to keep your identity confidential.
• Call 911 if the child is in immediate danger or a life-threatening situation
• If you suspect child maltreatment by a caregiver from a child care facility, call
1-800-859-0829 to make a report to the Division of Child Development and
Early Education (DCDEE).
What happens after a referral is made?
After you have discussed your concerns with a social worker at CPS, a determination is made as to whether
DSS will complete an assessment. If intervention is warranted, CPS may use either an investigative approach
or a family assessment approach to determine future actions and supports needed for the child and family.
NC’s Multiple Response System (MRS) is our state’s on-going effort to reform the entire continuum of child
welfare services in order to make child welfare more family centered and to keep children safe. MRS is com-
prised of seven separate strategies delivered to families through a practice model grounded in the use of
family-centered practice and system of care principles.
If a referral is not accepted for assessment and you still have concerns, you may request a review of the
agency’s decision by contacting the agency. If the decision is made by DSS not to file a petition and you do
not agree, you can request a review by the District Attorney.
Help can be provided to the family through:
• Counseling
• Referrals to other agencies
• Intensive in-home services provided by trained volunteers or professionals
• Help with housing, finances, medical needs, and child care
• Development of a Child and Family Team, meant to build a support network for the family
• Emergency foster care services
State of North Carolina
Department of Health and Human Services
Division of Social Services
www.ncdhhs.gov | www.ncdhhs.gov/dss
NC DHHS is an equal opportunity employer and provider.
PositiveChildhoodAllianceNC.org | 919.829.8009
