Last year, the Iowa Department of Human Services (DHS) determined more than 15,000 children in Iowa were abused.That is the highest number ever reported in Iowa. Resmiye Oral, MD, pediatrician and clinical director of Child Protection Program at University of Iowa Children's Hospital, talks about child abuse and neglect in Iowa:

When we think of child abuse, we may think of injury or sexual abuse, but are those the only examples of child abuse?   What would some other forms of child abuse be?

In addition to physical and sexual abuse you just described, the Iowa code recognizes seven other categories:

• Child neglect
• Exposing children to illegal drugs
• Manufacturing or possessing illegal drugs in the presence of a child
• Emotional abuse
• Prostitution
• Bestiality (sexual contact with animals in the presence of a child)
• Cohabiting with a sexual offender

In situation where some kind of child abuse is going on, who has the most power to save that child from being abused?   What should they do?

It varies from case to case. In shaken baby syndrome and sexual abuse of young children, for instance, the overwhelming majority of perpetrators are male caretakers with a significant number of the mother's boyfriend responsible for abuse. In these cases, the mother would be in a position to protect the child most probably by arranging alternative care for her child rather than her boyfriend.

Neglect on the other hand is perpetrated mostly by mothers since majority of child care is provided by mothers. In that case close relatives, day care providers, teachers may be in a position to observe and recognize the pattern, guide the mother for better care, and if all fails, inform DHS so services can be provided to the family and child can be protected.

Aside from physical injury, what kind of abuse can follow a child throughout their lives?

Emotional abuse is the core of all forms of abuse and neglect, especially if the abuse and neglect are chronic. Children living in abusive and/or neglectful households may suffer from a variety of emotional, behavioral, and developmental disturbances either due to abuse itself, or lack of stimulation and recognition, or the chaotic lifestyles that may go along with domestic violence, parental substance abuse, etc.

Are there certain characteristics of a child molester? What are they?

Unfortunately no. Child molesters may come from all walks of life. Majority of them are males, and may range in age from adolescence to elderly. In fact, adolescents make up 20 to 30 percent of child molesters. Most child molesters are young to middle age males. Since we can not recognize child molesters by any specific characteristics, it is best to educate our children regarding, good touch, bad touch, secret touch, ownership of and their rights on their bodies, and to tell if anybody touches them that make them feel uncomfortable.

How can someone outside the family identify a child who is being abused?

That may be a bit hard, too, since children have various levels of resilience. However chronically abused and neglected children may display depressive mood, behavioral problems including aggression, regression, low self esteem, bullying, etc, fear of places and people and innocent touches, reluctance to go home, and unexplained language and developmental delays among others.

If child abuse is suspected, what steps should be taken to protect the child?

The person who suspects abuse should call DHS 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 reporter should not worry about his/her identity being disclosed to the perpetrator, since DHS keeps that confidential. Following the report, a DHS worker visits the family and assesses social circumstances and the family needs to make it more functional.

If circumstances are deemed detrimental to the child's well being, the child may be removed and placed in a safe alternative care. The family is offered services in preparation for reunification.

Today, many counties are utilizing family conference system, which involves family members and their support systems working together with DHS to develop a recovery plan. The family's progress is assessed every six months to determine whether reunification is feasible. If not, at the end of 12-18 months, DHS may request termination of parental rights to put the child up for adoption.

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