Last year, the Iowa Department of Human Services determined more than 15,000 Iowa children were abused-that is the highest number ever reported in Iowa.

Resmiye Oral, MD,  pediatrician and clinical director of Child Protection at University of Iowa Children's Hospital, says all states recognize acts like deliberately injuring a child, failure to protect and feed, take sexual advantage of as abusive and or neglectful. "In Iowa, any caretaker's acts that physically or mentally injure a child, omission of necessary acts that cause the neglect of basic needs of a child, take sexual advantage of a child, or expose a child to illicit drugs and dangerous environmental factors would be recognized as abuse and or neglect.

In a way, she says, according to the recent Surgeon General's report on secondhand smoke, parents who smoke could be considered "abusing" their child - especially if that child has a respiratory condition. "Neglect involves the risk of harm in addition to actual harm. However, most physicians would prefer educating the parents as to these risks before filing a child neglect report. If it is clear that the child's deteriorating respiratory condition is due to second hand smoke exposure and parents fail to change their attitude, it would be reportable," she says.

Two of the causes for the increasing numbers of child abuse and neglect cases in Iowa may be because of worsening economic conditions and increasing immigrant population. "But I believe shrinking Child Protective services and major cuts to their preventive services also play a big role."

When child abuse is reported, a Department of Human Services worker visits the family and assesses social circumstances. If circumstances are deemed detrimental to the child's well being, the child is removed and placed in a safe alternative care. The family is offered services in preparation for reunification. The family's progress is assessed every six months to determine whether reunification is feasible. If not, at the end of 12 to 18 months the Department of Human Services may request termination of parental rights and place the child for adoption.

"If you know of a child you believe is being neglected or abused, you should call Department of Human Services right away and inform the intake worker of the name (date of birth if available) and location of the child. The names and locations of the caregivers and the suspected perpetrator will be helpful also. The caller should not worry about his/her identity being disclosed, since Department of Human Services keeps that confidential," says Oral.

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