In the state of Texas, licensed professionals in the health care, mental health, and child welfare industries are required to report suspicion of child abuse or neglect. Failure to do so can have grave consequences on both criminal and professional licensing levels. As such, it is essential that physicians and nurses, as well as licensed professional counselors, social workers, and psychologists understand the signs of abuse and the process through which they may fulfill their legal obligation if they have reason to suspect that abuse may be an issue.
Recognizing the Signs of Abuse
Abuse of a child can be physical, sexual, or emotional. This also encompasses neglect, which can be as simple as not providing for the basic needs of a child. Some of the most commonly seen signs include (not an exhaustive list):
- Genital bleeding, swelling, trauma, or mutilation;
- Sexually transmitted diseases for which there is no reasonable explanation;
- Retinal or subdural hemorrhages or bruising in infants;
- Abdominal distention, chest deformity, abdominal tenderness, absent bowel sounds, hematuria, or costochondral tenderness;
- Excessive bruising and/or patterned bruising, particularly those on the buttocks or extremities;
- Injuries that the child could not reasonably inflict upon themselves, particularly in those aged six months or younger;
- Illnesses, injuries, or behaviors for which there is no viable medical explanation;
- Poor weight, weight loss, or signs of excessive dehydration that have gone untreated;
- General hygiene issues, particularly in young children that are unable to fulfill hygiene needs themselves;
- An extensive history or pattern of injuries;
- Behavior or emotional response that is beyond what should be considered “normal” apprehension to a health care, mental health, or child welfare professional;
- Multiple fractures, either at once or in the child’s medical history;
- Soiled clothes, clothes in disrepair, or in clothing that is not appropriate for the weather;
- Reports caring for younger siblings or may give cues that expresses no adult is home to provide necessary care;
- Stealing, hoarding, or begging for food or frequent complaints of being hungry;
- General fear (or hatred/anger toward) parent or caregiver;
- Abnormal or excessive fear and/or frequent nightmares;
- Sudden changes in behavior, such as poor self-esteem, bedwetting, or aggression; and
- Extreme or inappropriate sexual behavior and/or affection.
There are also some less commonly seen signs, including folk remedies and culture-based practices that have the potential to cause harm. Physicians, nurses, licensed professional counselors, social workers, and psychologists should familiarize themselves with these practices since lack of knowledge is not a defense or protection against potential ramifications for failing to report abuse or neglect.
Fulfilling Your Obligation
If you have any suspicion of abuse or neglect, you must file a report with the Texas Department of Family and Protective Services. Reporting to your supervisor is not considered fulfillment of your responsibility, and you cannot delegate this duty to another person, such as a family member or coworker. You may use either the phone reporting system or the web-based e-Reporting system.
Consequences for Failure to Report
Failure to report suspected abuse can result in both criminal and licensing consequences. Criminally, you may be charged with a misdemeanor, which is punishable by imprisonment of up to 180 days and/or a fine of up to $2,000 (Texas Family Code, Chapter 261). You may also be subject to disciplinary action by the Texas Medical Board, Texas Board of Nursing, Texas State Board of Examiners of Psychology, the Texas State Board of Social Worker Examiners, or other state licensing board. Your license can also be suspended, revoked, or denied for renewal.
If you believe that your license is in jeopardy for any reason, contact a Texas professional license defense attorney immediately. Do not assume you will be treated fairly, and do not wait until matters have spiraled out of control. Oscar San Miguel, Attorney at Law, has more than two decades of experience in the medical field. Request a consultation today by calling 512-228-7946.