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The Role of Professional Child Care Providers in Preventing and Responding to Child Abuse and Neglect
Office on Child Abuse and Neglect, Children's Bureau. Karageorge, Kathy, Kendall, Rosemary|
|Year Published: 2008|
Minimizing the Risk of Maltreatment in Child Care Programs
Although the majority (86.6 percent) of reported child maltreatment incidents are perpetrated by family members, less than one percent are reported to have occurred in child care settings, including family, friend, and neighbor care outside the home, as well as in child care centers and family child care homes. Based on data gathered in 2006 from 39 States, 5,321 child daycare providers were found to be perpetrators of abuse or neglect. Of those child care providers found to be perpetrators, 14 percent of the cases involved physical abuse only; 53.8 percent involved neglect only; 21.9 percent involved sexual abuse only; 3.5 percent involved psychological maltreatment only, other, or unknown; and 6.7 percent involved multiple types of maltreatment.48 Therefore, it is important for early child care settings to establish policies and practices to protect children while they are in the child care environment.
High-quality child care programs have characteristics such as:
For additional information about high-quality child care, visit the National Child Care Information and Technical Assistance Center (NCCIC) website at http://nccic.acf.hhs.gov/topics/topic/index.cfm?topicId=5.
Staff Selection Procedures
There are no Federal laws that regulate licensing for workers in child care programs. In order to receive Child Care and Development Fund support from the U.S. Department of Health and Human Services, however, States must certify that they have established safety and health requirements, as well as procedures to ensure that providers comply with these requirements.50 In addition, federally funded Head Start programs have to abide by the Head Start Program performance standards, which include policies regarding reference and criminal background checks.51 Each State develops its own minimum standards for licensing early childhood programs. States use various methods to screen new child care workers, such as criminal records checks, child abuse and neglect clearances, and fingerprint records. They may require one, all, or a combination of these screening methods. Obtaining the results of these screenings can take from several days to many weeks. New employees for whom criminal background checks have not been completed should be placed with children only if a cleared staff person is within sight and is supervising the new employee at all times. In State-funded pre-kindergarten programs, if the teachers are public school employees, they are screened the same as any other public school teachers; if the funding goes to a local child care program, State child care licensing requirements apply.
Even with rigorous standards, it is not easy to predict which staff may maltreat children. However, child care programs need to take steps to minimize the possibility of such individuals being hired to care for children. The National Association for the Education of Young Children (NAEYC) has developed guidelines for screening and selecting appropriate individuals as staff, substitutes, or volunteers to work with children. The association recommends the following guidelines for screening, recruiting, and retaining staff:
- A basic screening should be conducted on all staff members, direct core staff, substitutes, managers, and volunteers, including bus drivers, janitors, cooks, and administrative assistants. The basic screening should include:
- A signed, written application;
- A careful review of the employment record;
- A check of personal and professional references;
- A personal interview.
- All potential employees and volunteers must be required to disclose any previous convictions, especially whether they have ever been convicted of any crime against children or of a sexual assault, which would preclude their being hired in a child care setting.
- All potential employees and volunteers should be required to provide at least three references from previous employers, parents of children served, or educational institutions. Child care programs should check these references carefully.
- All new employees and volunteers should be required to complete a supervised, mandatory probation period.
- Child care programs should have policies in place that are designed to retain competent staff and to remove others as necessary. Programs that provide competitive salaries, good benefits and working conditions, and regular opportunities for advancement are more likely to recruit and to retain competent staff.
- Clear procedures should be in place for responding to an allegation of abuse or neglect in the program. These procedures should address steps to protect children and to provide due process for the accused. Parents and staff should be informed of these procedures in the parent and staff manuals.52
The American Bar Association's Center for Children and the Law has identified several potential screening mechanisms for child care providers, including:
Staff retention is important in building a high-quality program. Staff who stay on the job benefit from supervision and development opportunities and gain experience that enhances their expertise. When a program has low turnover rates, children and their families are able to develop supportive, positive relationships with providers. Child-caregiver relationships evolve similarly to the attachments that children form with their parents. After children interact regularly with the same caregivers, the children often will seek contact or interaction with them when they are distressed. Distress can be caused by something minor, such as having a toy taken away by another child, or by something serious, such as maltreatment. Children prefer consistency in caregivers, and the stability of care is an important factor in children's development. Therefore, children in centers with high staff turnover rates often have a harder time attaching to new caregivers and establishing a secure child-caregiver relationship.54
NAEYC has outlined policies that early childhood programs can implement in order to prevent child maltreatment, including:
Staff Training and Development
One of the roles of the director is to provide or to oversee ongoing training programs to ensure that all staff continue to learn about young children, as well as to develop and to refine their caregiving skills. Providers having specialized training in child-related fields has been directly linked to improved quality in child care centers.56 Relevant, regular, and well-executed training also can affect staff retention positively, which benefits the program and the children.
Training in child care can be offered in many different ways. There is preservice training, which is provided before entering the field; orientation training when the employee first begins the job; and ongoing training that is recommended for staff to attend periodically. In addition to workshops and courses in child care and child development, training may include self-instructional curricula, conferences, or the use of an early childhood resource library. Training should be provided by specialists with extensive experience in child maltreatment prevention and intervention.
Many States require a certain number of hours of training for staff in licensed child care programs. The National Health and Safety Performance Standards, which are prepared jointly by the American Academy of Pediatrics, the American Public Health Association, and the National Resource Center for Health and Safety in Child Care and Early Education (with funding from the Maternal and Child Health Bureau, U.S. Department of Health and Human Services), offer guidelines for the topics and for the amount of training for child care providers.57 They suggest that all directors and caregivers should have at least 30 hours per year of continuing education during their first year of providing child care. Of those hours, 16 should be in child development programming, and 14 should be in health and safety practices. After the first year of employment, directors and staff should have 24 hours of applicable continuing education per year depending on individual competency needs.
The Child Development Associate (CDA) is a nationally recognized, competency-based training and credentialing program.58 In order to be considered for CDA credentialing and accreditation, an applicant must have 480 hours of experience working with children within the past 5 years and have completed 120 hours of training, with at least 10 hours in each of the eight CDA training areas. Training about the recognition and the prevention of child abuse and neglect is included in two of the training areas.
The Center for Child Protection and Family Support developed the following goals for staff training in order to reduce the risk of child maltreatment:
A more in-depth discussion of child care training is presented in 13 Indicators of Quality Child Care: Research Update, which is available at http://aspe.hhs.gov/hsp/ccquality-ind02/.
For additional information, visit the National Resource Center for Health and Safety in Child Care and Early Education, which is funded through the U.S. Department of Health and Human Services, at http://nrc.uchsc.edu.
Staff Supervision and Support
Effective staff supervision can help prevent abuse and neglect in child care settings. A director's ongoing, active participation in the daily operations of the program and the continual monitoring of adult-child ratios help to ensure that children are receiving quality care from skilled and caring staff. Caring for children can be a stressful job, and child care providers who are overwhelmed can lose control and lash out at children. As a result, the role of the child care providers' supervisor in preventing maltreatment includes identifying and alleviating some of the stressors in the workplace.
Staff stress and burnout can be affected by personal traits and by the work environment. It may be difficult or impossible for a director to alter or to address a caregiver's traits or personal stressors. However, program characteristics, such as the following, typically can be addressed:
Reducing Stress in the Workplace
Some examples of ways in which directors can create and maintain work environments that reduce, rather than contribute to, stress for employees include:
- Providing written job descriptions and personnel policies so that staff are clear about the program's policies, the performance expectations, and their own responsibilities;
- Maintaining a roster of qualified, available substitutes so that staff do not come to work sick because they fear that no one will be available to take care of the children;
- Monitoring the classrooms continuously to ensure that caregiver-child ratio targets are met;
- Using regular staff meetings as opportunities to discuss concerns of staff in order to help them feel supported and empowered;
- Including staff in decision-making, when appropriate, so that they can provide input regarding how the program operates and can gain greater control over their work environment;
- Recruiting, training, and scheduling volunteers (e.g., parents, retired caregivers) to assist during the busiest times of the day so that staff can provide individual attention to the children, plan classroom activities, and receive breaks;
- Creating mentoring relationships in which novice child care providers are paired with veteran colleagues who can offer advice and direction about handling stressful situations;
- Advocating for improved wages, paid overtime, 8-hour workdays, and additional benefits so that staff will be compensated adequately;
- Showing respect and regularly acknowledging accomplishments of staff in order to demonstrate that they are valued;
- Making sure there is always someone on call so that staff who recognize that they are feeling overwhelmed can take a break from being with the children;
- Providing a pleasant, comfortable place with adult-sized furniture for staff to use on breaks so that time away from the children can be relaxing and rejuvenating.
Supervisors also can help the staff to identify and to develop satisfying and rewarding features of their job, such as:
- Observing the children's developmental or behavioral progress;
- Identifying the positive relationships they build with the children in their care;
- Acknowledging the challenges of the work;
- Taking pride in providing a needed service;
- Noting meaningful relationships with the parents;
- Receiving recognition from colleagues and supervisors for good performance.
Recognizing the Potential to Maltreat
There is no single, known cause of child maltreatment, nor is there a single description of either those who maltreat or those who are victims of child maltreatment. Child maltreatment occurs across all socioeconomic, religious, cultural, racial, and ethnic groups. Individuals who have the potential to maltreat children may be educated or have received training in the early childhood field, but many have unrealistic expectations about what children are able to do at various stages of development. They either have little knowledge of child development or do not apply the knowledge they have. They may have strong beliefs that the only way to get children to do what they are supposed to do is to punish or to threaten them. Often, abusive or neglectful caregivers use harsh discipline techniques or always use the same technique regardless of the child's age or of the specific situation.
When supervisors witness inappropriate behaviors during formal and informal observations of staff, they should take objective notes that state exactly what the person did and said rather than paraphrasing, summarizing, or making judgments. If possible, they should write down direct quotes of what the adult and the child said. The supervisor should promptly schedule a time to meet with the individual to provide feedback related to the observation. During the feedback session, the supervisor and the staff member can jointly develop a plan for improving the quality of the individual's interactions with children. The supervisor should continue to observe this staff member and to look for signs of improvement. If the staff member's skills do not improve after repeated observations and feedback sessions, the supervisor must use professional judgment to determine whether this staff member should be terminated. Termination is an appropriate response when the staff member has clearly violated program policies and when it is clear that the behavior is detrimental to the children. This decision should be made based on objective information and observations.
At times, supervisors may witness staff behaviors, such as slapping or punching a child, which not only are clear infractions of the program's policies regarding staff and child interactions, but also are grounds for immediate termination. In these instances, the program should follow established procedures for terminating employment. Some of these infractions also may be considered abuse or neglect legally and, therefore, must be reported to the appropriate authority, such as child protective services (CPS) or law enforcement.
As supervisors observe staff interaction with children, they should take note of behaviors that may be signs that the individual has the potential to maltreat, including:
Many early childhood education programs have adopted the following policies and practices in order to minimize the risk of child maltreatment occurring in the program:
- Providing open access to parents;
- Minimizing opportunities for adults to be alone with children;
- Preventing unauthorized access to the center and the children;
- Preparing written accident reports;
- Establishing written policies about how to discipline children;
- Establishing written policies about the appropriate and the inappropriate touching of children;
- Developing written policies for reporting suspected child abuse or neglect;
- Communicating policies with parents;
- Networking with early childhood and family support professionals;
- Providing a daily program that supports positive social and emotional development for children.
Providing Open Access to Parents
Most early childhood education programs encourage parents to make unannounced visits at any time during daily operations. In larger centers, parents should be required to check in with the director or supervisory staff before visiting the center, including their children's classrooms, the outdoor play area, and the other activity rooms in the center or home. In smaller or family child care centers, parents should make sure that the director or other staff are aware they are visiting. In addition, programs should emphasize that parents and early childhood education professionals are partners in keeping children safe and in promoting their growth and development. Programs should provide many opportunities for parents to become actively involved. In addition, the local phone number for reporting suspected child abuse and neglect should be posted prominently on the parent bulletin board.
Minimizing Opportunities for Adults to Be Alone with Children
The program facility can be designed to minimize opportunities for adults to be alone with children in hidden areas and to reduce the risk for maltreatment. Because many reported instances of sexual abuse in child care facilities occur during toilet training, many programs are redesigning bathrooms so they are no longer private, enclosed areas where children might be isolated with an abusive adult. Some centers have removed or minimized the doors and partitions. New centers typically design bathrooms as open areas. As a further precaution, when children come in from outdoors to use the toilet, programs require them to be accompanied or supervised by an adult. In rooms where infants and toddlers receive care, the diapering areas are positioned so that they are visible to all the adults in the room.
Other design changes that minimize opportunities for adults to be alone with children include removing curtains, shades, or inside locks on closets or workrooms. When centers have outdoor storage areas, they should be visible from the main building. In some centers, to ensure that parents and supervisors can observe staff while they are caring for children, classrooms have windows or other means of viewing activities from the outside and the hallways. These windows must be left uncovered, with no artwork, draperies, or blinds that hamper viewing.
If a caregiver is left alone with children, recommended maltreatment prevention procedures suggest that the single-caregiver location be visited on an unannounced basis by another staff member (administrative or caregiving) during operating hours. Centers may choose to add cameras or convex or concave mirrors to assist in continuously monitoring the classrooms. Additionally, many programs establish rules that prohibit staff members and volunteers from taking children from the center without a parent's written permission except for a pre-approved group activity or an approved medical visit.
Preventing Unauthorized Access to the Center and the Children
To provide adequate supervision, it is necessary to control access to the center by individuals who are not staff or parents. Centers should establish rules, such as:
- All visitors and volunteers must sign in and sign out when visiting the center, and visitors must be escorted.
- The use of name tags by staff and authorized adults should be required. Staff should be encouraged to question adults who are not wearing name tags.
- Friends or family members of staff may not be present in the center unless they are approved volunteers or have permission to visit.
- A staff member must be present at the main entrance at all times to monitor the exit and the entry of adults and children.
- The entry through secondary entrances should be monitored.
Preparing Written Accident Reports
No matter how stringent a program's safety precautions, children can have accidents while they are in child care. The accidents may be minor and involve scratches or small bruises or they may be serious enough to require medical attention. Regardless of how severe the child's injury, the program should notify the parents immediately and complete an accident report with a copy provided to the parents. The accident report will provide some protection against parent allegations that their child was maltreated while at the program.
In addition to accident reports, programs should conduct daily screenings as children arrive in the morning and before the parents leave. During these screenings, the child care provider should check for and record any illnesses or unusual marks or bruises. These records can document that a child arrived with the injury and that the injury did not occur at the program. Staff also should discuss with the child how any unusual marks or injuries were sustained. (For more information on this topic, see Chapter 3, Reporting Suspected Child Abuse or Neglect.)
Establishing Written Policies About Disciplining Children
Written policies related to appropriate discipline techniques are useful tools for informing parents and staff of the program's philosophy for guiding children's behavior and should serve as part of the framework for staff training. The policies should be included in the parent handbooks and distributed to new staff as part of the orientation process. Some agencies require new staff to sign a statement indicating that they have read and understand the policies, as well as understand the consequences of not complying.
Written discipline policies should:
- Provide a statement of the program's philosophy regarding guiding children's behavior;
- Give examples of positive guidance techniques for children of different ages;
- Include guidelines in accordance with any laws regarding the use of corporal punishment;
- Indicate who will discipline children and under what conditions;
- Provide examples of inappropriate children's behaviors that are not tolerated;
- Identify the point at which parents will be asked to participate in planning strategies to help children overcome troublesome behaviors (e.g., biting or having tantrums);
- Address how staff will assess the effectiveness of the discipline techniques used.
Establishing Written Policies About Appropriate and Inappropriate Touching of Children
An essential part of providing care for young children is holding, hugging, and otherwise touching them in a positive, affectionate manner. A program's touch policy can be very brief and to the point, such as, "Children may be touched when it is appropriate and respectful and makes the children feel good, but they will be left alone when they prefer not to be touched." It is inappropriate for staff to force children to have physical contact. It is very important for programs to make it clear to staff and to parents that, except in situations where safety is an issue, children always have the option of indicating that they do not want to be picked up, to be hugged, to have their back rubbed, or to have their hand held. Child care providers need to understand that they must never touch children for their own personal satisfaction. (See Appendix F, Risk Indicators: Touch Policy, for more information on this topic.)
Developing Written Policies for Reporting Suspected Child Abuse or Neglect
Written policies should describe the program's guidelines about who reports, when to report, and how to report suspected child abuse or neglect. Staff should become familiar with these policies during their orientation, and they should review them during regularly scheduled training on the recognition and on the prevention of child abuse and neglect. Written policies should be reviewed periodically by the director to make sure they reflect current best practices. Important issues to consider in designing these policies are included in Chapter 3, Reporting Suspected Child Abuse or Neglect.
Communicating Policies with Parents
Child care providers should have clear, written policies to share with parents when an agreement is reached to provide child care. Both the parent and the provider should sign a simple contract that lists the program's policies. This protects both the program and the parent. While this contract may not be legally binding, it makes clear at the beginning of the relationship what the expectations are for the parents and the providers. This agreement also can be the basis for resolving later disputes. The contract should note:
- Hours of service;
- Parental visitation policy;
- Consequences for the late pickup of children;
- Agreement about who is allowed to pick up the child;
- Information about the daily health screening of children;
- Legal mandate of the child care provider to report any suspicion of child abuse or neglect.
Signing the contract also provides a good opportunity for programs to share their discipline policies with parents.
Child care programs should have forms that are used routinely to report health and safety issues. Caring for Our Children: National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care, Second Edition, which includes information about how to make child care centers and family child care homes safe for children, provides sample forms that child care providers can use to document health situations.60 The document is available from the National Resource Center for Health and Safety in Child Care and Early Education at http://nrc.uchsc.edu/CFOC.
Networking with Early Childhood and Family Support Professionals
Professional organizations, such as the National Association for Family Child Care, NAEYC, or networks for family child care providers (such as those supported by the military) offer opportunities for networking and training. Providers can meet with peers, learn strategies, explore professional and ethical responsibilities, and create relationships that will help providers who are working with a child who has been maltreated. Professional organizations also may offer discounted rates for professional insurance.
Child care providers should maintain a listing of resources for themselves and for the children and families in the program. The following can be placed in a resource guide:
Providing a Daily Program That Supports Positive Social and Emotional Development
Child care providers should offer a predictable daily routine that includes active and quiet activities and healthy nutrition. They should plan activities that are appropriate and stimulating and that meet the individual needs of the children in their care. Planning should cover all areas of child development, including positive social and emotional development and early learning. Since research shows that television and videos can support both social and antisocial behaviors, providers should be thoughtful in the use of television and videos. The Center on the Social and Emotional Foundations for Early Learning (CSEFEL) develops and disseminates evidence-based, user-friendly information to help early childhood educators meet the needs of the growing number of children with challenging behaviors and with mental health needs in child care and Head Start programs. This information is especially important to providers because some studies show these children to be at a higher risk of child abuse and neglect.61 For more information, visit the CSEFEL website at http://www.vanderbilt.edu/csefel/.
Some children are more susceptible to being maltreated than others. In general, children who are perceived by their parents as "different" or who have special needs—including premature babies or children with disabilities, chronic illnesses, Attention Deficit and Hyperactivity Disorder, or difficult temperaments—may be at greater risk of maltreatment.62 National studies have found that children with disabilities were 1.7 times more likely to be maltreated than children without disabilities.63 They also may be more vulnerable to repeated maltreatment because they may not understand that the abusive behaviors are inappropriate or because they may be unable to escape or to defend themselves. Various researchers and advocates have suggested that some societal attitudes, practices, and beliefs that devalue and depersonalize children with disabilities sanction abusive behavior and contribute to these children's higher risk of maltreatment.64 See Appendix G, Risk Indicators: Developmental Expectations of Children, Particularly Those with Special Needs, for information on how to assess whether child care providers have inappropriate developmental expectations of children with special needs.
Another way to help prevent or to respond to child abuse and neglect is by having children's books available that encourage positive, caring behavior and that teach children to respect themselves and their bodies. The local children's librarian can be an excellent resource for identifying which books are appropriate for children of different ages and situations. Providers should share information about these books with parents and select books that are acceptable to all their families. Providers also can use children's books to conduct early education activities with children and their parents to facilitate early learning and to support school readiness.
Early childhood generally refers to the period from birth through age 5. A child's early cognitive development, including skills such as pre-reading, language, vocabulary, and numeracy, begins from the moment a child is born. Developmental scientists have found that in the first year of life, even before a child can speak, the brain acquires a tremendous amount of information about language. A strong connection exists between the development a child undergoes early in life and the level of success that the child will experience later in life.65
When young children are provided with an environment rich in language and literacy interactions and opportunities to listen to and to use language constantly, they can begin to acquire the essential building blocks for learning how to read. A child who enters school without these skills runs a significant risk of starting behind and of staying behind. The Bush Administration's early childhood initiative, Good Start, Grow Smart, helps States and local communities strengthen early learning for young children in order to ensure that they are equipped with the skills needed to start school ready to learn.66 For more information on Good Start, Grow Smart, visit http://www.whitehouse.gov/infocus/earlychildhood/earlychildhood.html.
Exhibit 4-1 provides a quick guide on how various types of risks can be minimized through effective procedures in both centers and family child care homes.
Topical Guide to Organizational Risk Assessment67
|Screening and Selection Procedures for Staff and Volunteers|
|Written Policies and Procedures|
|Physical Environment and Program Factors|
|Child and Parent Prevention Programs and Parental Involvement|
|Community Network of Integrated Services and Resources|
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