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The Role of First Responders in Child Maltreatment Cases: Disaster and Nondisaster Situations
Office on Child Abuse and Neglect, Children's Bureau. Cage, Richard., Salus, Marsha K.|
|Year Published: 2010|
Responding in Disasters
In This Chapter
- Factors for first responders
- Child responses to disasters or other trauma
- Agency preparation
- Agency response
Responding to a case of possible child maltreatment can be complex and stressful. The difficulty of this situation can be compounded in the midst of or directly after an emergency, such as natural disasters (e.g., hurricanes, floods), manmade disasters (e.g., terrorist attacks, hazardous materials), or urgent medical emergencies (e.g., outbreaks of infectious disease). As communities try to cope during or in the aftermath of a disaster, some individuals may react in ways that could harm themselves and others. Some studies have shown increases in rates of child maltreatment and domestic violence after disasters.125 Additionally, there may be a short-term increase in alcohol and drug abuse, which increases the risk for child maltreatment, among other social problems (e.g., domestic violence, driving under the influence).
Although much of the information provided in this manual can be applicable in disasters, first responders will have other factors to consider as they respond to possible cases of child maltreatment during disasters. These factors include more pronounced immediate safety concerns, being unable to communicate with their agency or other agencies or service providers, and additional emotional trauma, both for the alleged victim and the first responder. This chapter provides information about the additional factors that first responders should consider, as well as ways first responder agencies can better prepare for disasters.
Factors for First Responders
Although no one can prepare for all the situations that may arise during a disaster, research and reports from the field can provide first responders with information that may assist them if a disaster were to occur. This section highlights issues, such as child responses to trauma and disaster, self-care, and changes a community may experience post-disaster, to help first responders prepare for and respond to a disaster.
Child Responses to Disasters or Other Trauma
Children may react to trauma, such as disasters, immediately or days or even weeks later. Many children experience a loss of trust in adults or a fear that the event may occur again. The following describes reactions children and adolescents may have, according to their age, either immediately or some time after a traumatic event:
Ages 5 years and younger. Reactions may include a fear of being separated from the parent, crying, whimpering, screaming, immobility or aimless motion, trembling, frightened facial expressions, excessive clinging, and regressive behaviors (e.g., thumb-sucking, bedwetting, fear of darkness). Children at this age tend to be strongly affected by their parents' reactions to the traumatic event.
Ages 6 to 11 years. Reactions may include extreme withdrawal, disruptive behavior, inability to pay attention, regressive behaviors, nightmares, sleep problems, irrational fears, irritability, problems in school, outbursts of anger and fighting, complaints of stomachaches or other bodily symptoms that have no medical basis, depression, anxiety, and feelings of guilt and emotional numbing or "flatness."
Ages 12 to 17 years. Reactions may be similar to those of adults and include flashbacks, nightmares, emotional numbing, avoidance of any reminders of the traumatic event, depression, substance abuse, problems with peers, antisocial behavior, withdrawal and isolation, physical complaints, suicidal thoughts, school avoidance, academic decline, sleep disturbances, confusion, extreme guilt over perceived failure to prevent injury or loss of life, and revenge fantasies.126
Children may react differently to disasters or other trauma based on the characteristics of the event, the child, and the child's family and community. See Exhibit 5-1 for more details on these characteristics.
Experiencing Disasters: The Risk of Trauma-related Problems127
|The following characteristics influence to what extent a child may experience problems after a disaster or other traumatic event:|
|Characteristic of the Event||Characteristic of the Individual||Characteristic of the Family and Community|
|Increase risk of trauma-related problems||
|Decrease risk of trauma-related problems||
The disaster may interfere with first responders' capacity to respond to the suspected child maltreatment in the manner described previously in this manual. They may need to adjust their response based on the particular circumstances of the maltreatment and disaster. Conducting a full investigation of possible child maltreatment may not be possible during a disaster, but the following are ways a first responder can assist children during a disaster:
- Protect the children from
- Further harm
- Traumatic sites and sounds
- Onlookers and media
- Be kind, but firm, in directing them
- Away from the disaster site
- Away from injured survivors
- Keep children together with family and friends (when this will not compromise the safety of the child)
- Identify children in acute distress
- Stay with them until they are calm
- Recognize they may tremble, ramble, become mute, or exhibit erratic behavior, including rage, loud crying, or remaining completely still
- Be tolerant of difficult behavior and strong emotions
- Act in a way that supports and reassures the child.128
First responders also can help children or adults address immediate needs or concerns (e.g., obtaining food or shelter, finding a family member) by guiding them in:
- Identifying the most immediate needs or concerns
- Discussing an action plan and setting reasonable goals
- Taking action to address the need.
Aside from meeting immediate needs or concerns, this process can also help individuals, including first responders, cope with feelings of loss of control or failure.129
First responders who encounter a child who is emotionally overwhelmed (e.g., appears disoriented, is unresponsive, is uncontrollably shaking) can attempt to stabilize and orient the child. Being with a parent or other family member who is calm and coping well is an important way to help calm a child. If the child's family is unavailable, or if they appear to be emotionally overwhelmed and not able to calm the child, first responders can try to stabilize them using a "grounding" technique (i.e., helping them focus on nondistressing thoughts or things outside of themselves). First responders should request that the distressed individual:
- Sit in a comfortable position
- Breathe in and out slowly and deeply throughout the process
- Name five nondistressing items he can see (e.g., a table, a cloud)
- Name five nondistressing sounds he can hear (e.g., his own breathing, the wind blowing)
- Name five nondistressing things he can feel (e.g., the blanket on his body, his feet against the floor).130
If first responders are attempting to ground younger children, they can make alternative, more developmentally appropriate requests, such as naming five colors they can see or imagining a favorite playground or storybook character. If this process does not calm the individual, first responders should consult with medical or mental health professionals.131
|Psychological First Aid|
The National Child Traumatic Stress Network and the National Center for PTSD (Post-Traumatic Stress Disorder) developed the Psychological First Aid (PFA) Field Operations Guide to assist mental health and other disaster response workers who provide early assistance to children and adults affected by a disaster or other emergency. Basic objectives of PFA include:
Appendix N features the Assessing Disaster Survivor Immediate Needs Worksheet from this guide. The complete guide can be found at http://www.nctsnet.org/nctsn_assets/pdfs/pfa/2/PsyFirstAid.pdf.
For additional information about providing services to children affected by disasters, visit the Child Welfare Information Gateway website at http://www.childwelfare.gov/management/disaster_preparedness/.
Self-care for First Responders
In addition to ensuring the safety of children and families, first responders should ensure that they are taking care of their own mental and physical health and safety throughout and after their work during disasters, during which a "normal" case may be compounded by mass casualties, destruction, chaos, or other impending danger. (Note: Some of this information also will be applicable for nondisaster situations, when responding to possible cases of child maltreatment may also be stressful and emotional for the first responder.) Responding during a disaster can affect an individual's mental and physical health immediately or days, weeks, or months after the event.
The stress of working during a disaster takes a toll on first responders. Being involved in a disaster undoubtedly will affect an individual, and first responders may exhibit normal feelings and reactions, such as:
- Being profoundly sad, grief stricken, and angry
- Not wanting to leave the scene until the work is finished
- Trying to override stress and fatigue with dedication and commitment
- Denying the need for rest and recovery time.133
First responders also may exhibit stress symptoms during or after the disaster that disrupt their normal life and for which they should seek assistance. Exhibit 5-2 lists some of these symptoms.
Stress Symptoms That May Be Experienced by First Responders in Disasters134
* Seek medical attention immediately if you experience these. Symptoms of shock include shallow breathing, rapid or weak pulse, nausea, shivering, pale and moist skin, mental confusion, and dilated pupils.
While responding during a disaster, first responders can take several steps to help them stay focused and manage their stress, including:
- Pacing themselves
- Taking frequent breaks, when appropriate
- Taking care of each other
- Eating and drinking enough
- Communicating with loved ones
- Recognizing and accepting their limitations
- Limiting on-duty rotations to 12 hours per day, if possible
- Using counseling assistance programs, if available
- Participating in memorials, rituals, or other methods of expressing their feelings.135
These steps may vary, of course, depending on the specifics of the disaster.
First responders may have multiple roles during the course of a disaster. In addition to their professional or volunteer role as a first responder, they also may be victims. The first responder agency should recognize that some staff may not be physically or emotionally available to assist with the disaster response because they or their family have been affected and require immediate and long-term assistance.136
First responder agencies at the Federal, State, and local levels should have plans that outline how their operations will continue or be adapted during and after a disaster or other emergency. This section explores how agencies can prepare for disasters by developing Continuity of Operations Plans (COOPs), coordinating with key partners, and training staff about agency protocols and how to respond.
Assessing Possible Disasters
Before agencies can plan how they will react to a disaster or other emergency, they first must determine what types of events they might need to react to and how those events may affect their operations. Agency staff can develop a list of potential disasters for their area. For example, a large, urban area in the Northeast may want to consider the effects of blizzards, hurricanes, terrorist attacks, or an epidemic and a small, rural community in the Midwest that is adjacent to a chemical plant might be more prone to flooding, tornados, and chemical exposure. This does not mean that agencies should only plan for the most obvious types of disasters, but they may want to dedicate more planning time to disasters that are more likely in their area. Additionally, the agency should consider disasters of different scopes (e.g., a localized fire at the child welfare agency versus widespread fires throughout the community). When determining the possible effects of a disaster, the agency should also review how the disaster might affect partner agencies and how that might affect its own ability to provide services.
Developing a Disaster Plan
The disaster plan will assist the agency in continuing to provide services and respond to cases in the event of a disaster. The plan, at a minimum, should contain information about who has the authority to activate the plan, essential functions that should be performed and by whom, the members of the emergency management team, and the communication process.137 This disaster plan may include a COOP, or the entire plan may be part of a COOP. A COOP outlines how an organization will maintain its essential functions in the event of a disruption or emergency. Appendix O, Continuity of Operations Plan (COOP) Outline, is a COOP guide developed by the Federal Emergency Management Agency (FEMA).
|Federal Requirements Regarding Child Welfare Disaster Planning|
In 2006, the Child and Family Services Improvement Act (P.L. 109-288) mandated that in order to receive funding, States must describe in their Annual Progress and Services Reports how their child welfare systems would respond to a disaster. Specifically, States must outline how they will:
An essential component of the planning process is determining how agency files and data can be securely stored and how they can be accessed during or after a disaster. In a review of the challenges encountered and lessons learned about protecting and educating children during and after Hurricanes Katrina and Rita, the U.S. Government Accountability Office (GAO) reported that data and record management was a key issue. Louisiana was in the process of developing a statewide child welfare information system, but it did not have extensive case information in a central database. Accordingly, child welfare agencies had difficulty contacting foster parents because their case records were limited and often inaccessible for weeks after the storm, and some court proceedings related to adoption and reunifications were delayed because records were inaccessible or had to be recreated by the caseworkers from memory.139
To prepare for a disaster, agencies should store critical information in a statewide or other central database that is backed up and accessible in an emergency. Information that may need to be accessed in an emergency includes:
- Disaster plan details
- Case and client records
- Contact information for staff, families, providers, and youth
- Human resources information (e.g., employee information, payroll systems).140
Agencies may want to assign and set aside time and resources for one person to oversee the development of the disaster plan. This person would be responsible for:
- Ensuring the plan is developed through a collaborative process
- Communicating the plan within the agency and community
- Coordinating the plan with any statewide or other local emergency management processes
- Ensuring agency involvement in any State or local practices or drills
- Reviewing and updating the plan periodically based on stakeholder feedback and changes in policies or circumstances.141
|Key Questions to Consider When Developing a Disaster Plan|
|The following are some questions agencies should consider when developing a disaster plan:
Coordinating With Key Partners
As first responders know, disasters rarely affect only one service provider or group within a community. A comprehensive response to a disaster usually will require the assistance of multiple agencies, organizations, and individuals at the local, State, and Federal levels. Working with partners at all levels will help the agency:
- Be knowledgeable about emergency response plans at various levels
- Determine how the agency's disaster plan or services may be incorporated into or complement partners' plans
- Clarify the agency's role in the response to a disaster
- Establish who has decision-making authority and in what circumstances
- Share information about who the liaisons between the partners are
- Determine where emergency services are located during a disaster, as well as if and how the agency can assist
- Advocate for the needs of agency clients, staff, and volunteers
- Seek agency participation in emergency response drills
- Establish data-sharing agreements to help locate displaced children and families after a disaster.143
It is important that agencies know before a disaster occurs which partners they will need to work with and how they will work together. One of the lessons learned from the GAO's review of the response to the Gulf Coast hurricanes was that standing agreements among State child welfare officials and the American Red Cross and FEMA regarding coordination and data sharing could have expedited recovery efforts. For example, GAO reported that by the time Louisiana officials had developed a memorandum of understanding (MOU) with the Red Cross to search its shelters for foster children, the Red Cross had closed its shelters.144 (For more information about MOUs, see Appendix K, Memorandum of Understanding.)
|Partnering With Community and Faith-Based Organizations|
A recent study about the role of community and faith-based organizations in the responses to Hurricanes Katrina and Rita indicates that it is important to include these organizations in the disaster planning process. Child welfare agencies can determine which community and faith-based organizations are in their area, the nature of their work, their capabilities, how they may fit into the agency disaster response, and prior experience, if any, in disaster planning or response.145 Then the agency can work with appropriate organizations to craft and revise the disaster response plan and train them in pertinent disaster response methods and issues.
First responder agencies should provide comprehensive training to staff about the agency's response and operations during a disaster. Agencies can provide training to new staff during their orientation and provide ongoing training at regular intervals to existing staff. Additionally, agencies should include contracted staff in disaster preparedness and response training. The following are important topics to cover during these trainings:
- The agency's disaster plan
- How the plan will be adapted to changing circumstances (e.g., in different types and scopes of disasters)
- The emergency management team and the delegation of authority
- The roles and expectations of various staff, including when and how they are to check in with the agency if a disaster occurs
- How to communicate with other staff and agencies during a disaster
- Critical personal and professional items they should have on hand in case a disaster occurs (e.g., flashlight, walking shoes, caseload list).146
|Disaster Preparation for Children and Families|
|In addition to ensuring their staff are properly trained for disasters, child welfare agencies should encourage children, youth, and families involved with their agency to develop their own disaster plans that include:
Agencies should provide training and information to families about how to develop their plans, what to do in the event of a disaster, and how their children may react.147
During a disaster, first responder agencies need to recognize and assess the immediate needs of the community. It is essential that the agencies remain in contact and coordinate their efforts, hopefully following the steps and protocols laid out in their disaster plans. Although much of this information may already be outlined in their disaster plans, agencies should ensure they are taking the following steps during disasters, where appropriate:
- Establish contact with families, providers, children, and youth in the child welfare system by methods such as operating a call-in line or contacting or coordinating with other systems that may be in contact with them
- Maintain a database to track contact with clients, including whether their whereabouts or conditions are known
- Identify children who are separated from their families
- Conduct an initial assessment of the locations and needs of individuals involved with the child welfare system
- Provide information, support, and services for these families, including what services are available near their current location.148
|Reconnecting Families After an Emergency|
To assist States, Tribes, counties, and other child welfare agencies in helping families who have become separated during a disaster, the National Resource Center for Child Welfare Data and Technology (NRCCWDT) developed the Reconnect Families Database. This system, which was based on a database application developed in Louisiana after Hurricane Katrina, helps child welfare agencies track children's whereabouts and well-being and identify those who have not yet been reunited with their families. It allows agencies to track children, adult family members, placement providers, and agency workers. Additional information about the Reconnect Families Database can be found on the NRCCWDT website at http://www.nrccwdt.org/resources/disaster/disaster_db.html.
First responder agencies should recognize that their staff will have personal needs during and after a disaster. Agencies can assist their staff by providing additional support, such as flexible hours and making sure their basic needs are met (e.g., advocating for them having priority for emergency housing). Additionally, agencies may want to have counseling available for staff to help them to overcome the stress and emotional toll of the disaster and to process the situation.
In the wake of a disaster, child welfare agencies may want to consider providing additional programs and services to children and families, including:
- Trauma services for children, youth, and families
- Assistance for medically fragile children and their caregivers
- Additional time for service visits
- Child care for families seeking help
- Extra assistance for foster families.149
A critical component of an agency's post-disaster plan is determining the strengths and weaknesses of its approach during the disaster. The agency should conduct debriefing sessions to capture information about how the agency responded and if it met the needs of children and families. The debriefing sessions should include managers, staff, clients, partnering agencies, and other stakeholders. Important areas to assess include:
- Service delivery
- Collaboration with partners
- Contracted services
- Management of staff
- Information systems.150
The agency should analyze the information gathered during these sessions and use it to amend its disaster plan, as necessary.
The following documents may be useful in helping child welfare and other agencies prepare for and respond to disasters:
- Coping with Disasters and Strengthening Systems: A Framework for Child Welfare Agencies (http://muskie.usm.maine.edu/helpkids/rcpdfs/copingwithdisasters.pdf)
- Disaster Preparedness Resource Guide for Child Welfare Agencies (http://www.caseyfoundation.com/~/media/Pubs/Topics/Child%20Welfare%20
- Preventing Child Abuse and Neglect in Disaster Emergency Shelters (http://www.nrccps.org/resources/disaster_emergency_shelters.php)
- Ready for Anything: A Disaster Planning Manual for Runaway and Homeless Youth Programs (http://www.ncfy.com/publications/pdf/ready_for_anything.pdf)
The following organizations offer useful resources that address disaster preparedness and response:
- American Bar Association Center on Children and the Law (http://www.abanet.org/child/disater/disater_materials.html)
- National Resource Center for Child Welfare Data and Technology (http://www.nrccwdt.org/resources/disaster/disaster.html)
- National Resource Center for Permanency and Family Connections (http://www.hunter.cuny.edu/socwork/nrcfcpp/disaster_relief.html).
First responders play an invaluable role in preventing, identifying, and responding to child maltreatment in both nondisaster and disaster situations. The ability of first responders to assess situations, provide immediate assistance to children and families, conduct interviews, and collect evidence is critical to the successful investigation and, if necessary, prosecution of suspected cases of child abuse and neglect. Since they often respond to and investigate the same cases, it is essential for each type of first responder to understand the roles and responsibilities of the others. By working collaboratively, first responders can enhance outcomes for children and families.
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