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Abandonment The act of a parent or caretaker leaving a child
for an excessive period of time without adequate supervision or provision for
the child's needs. State laws vary in defining adequacy of supervision and the
length of time a child may be left alone or in the care of another before
abandonment is determined.The age of the child is also an important factor in
determining whether the child has been abandoned.
Abdominal Distention Swelling of the abdomen (the area
located between the chest and pelvis), which may be caused by internal injury,
bowel blockage, or malnutrition.
Abnormal Deviating from the standard; not average; typical
Abrasion A wound in which either skin or mucous membrane
have been scraped off.
Accidental death A mode of death indicating non-intentional
trauma. See Mode of Death; and
Intentional and Non-Intentional Injury.
Accountability The measurable extent to which an
organization, individual, or the general public keeps the promises made to the
people served.Most often this involves providing assurance to someone or some
organization that expected action occurred.
Accused See Defendant.
Acute In medicine, refers to a health effect that is brief,
intense and short term. (as compared to chronic).
Acute Pancreatitis An acute inflammation of the pancreas
(the organ in the body which produces and secretes the enzymes which aid
digestion). Symptoms include serve abdominal pains, nausea and fever. In
children, trauma should be considered as a possible cause.
Addiction Over-dependence on the intake of certain
substances (such as alcohol, nicotine, and other drugs) or performing certain
acts, such as smoking. Inability to overcome a habit or behavior pattern.
Adjudication (Adjudicatory Hearing) In a child welfare case,
the hearing in which the court determines whether a child has been maltreated
or whether there is some other basis for the court to take jurisdiction (or
authority) over the case.
The grounds upon which the court may take jurisdiction vary from state to
state. If the court finds that there is a basis for jurisdiction, the next
stage of the process is the disposition hearing.
Adoption A legal process that vests all legal rights and
responsibilities of the parenthood in persons other than the childs biological
or previously adoptive parents.
Anemia Any condition in which the number of red blood cells
(carriers if oxygen throughout the body) are less than normal.
Anorexia Lack or loss of appetite for food.
Anorexia Nervosa A personality disorder manifested by an
extreme aversion to food. It usually, but not exclusively, occurs in young
women. May include bingeing and purging (Bulimia).
Anterior In human anatomy, the front surface of the body.
Apnea The absence of breathing.
Appeal In law, resort to a superior (appellate) court or
administrative agency to review the decision of an inferior court (trial or
lower appellate) or administrative agency.
Arraignment One of the first steps in the criminal process
in which a defendant is formally charged with an offense and informed of
his/her constitutional rights.
Asphyxia Death caused by being deprived of oxygen. Can be
caused by strangulation, suffocation, choking, or smothering.
Assault The attempt to inflict bodily injury on another
person, with unlawful force and the apparent ability to inflict the bodily
injury unless stopped. Assault is both a crime and a tort (private/civil
Atrophy Wasting away of flesh, tissue, cell, or organ.
Autism A syndrome appearing in childhood with symptoms of
self-absorption, inaccessibility, aloneness, inability to relate to others,
highly repetitive play and language disturbances. The cause is unknown.
Autopsy The dissection of a dead body for the purpose of
inquiring into the cause of death. Also, port mortem examination to determine
the cause or nature of a disease. An autopsy is normally required by statute
for violent, unexpected, sudden or unexplained deaths.
Avitaminosis A condition caused by the lack of one or more
essential vitamins, which may be caused by lack of vitamins in the diet or by
the body's inability to use the vitamins because of disease.
Avulsion A forcible separation or tearing away of a body
part or tissue.
Baby Gram (Slang) One or two x rays
taken in order to see all of a babys body at one or two angles (often
Battered Child Syndrome A term describing a combination of
physical and other indicators that a childs internal and external injuries
result from acts committed by a parent or caretaker. In some states Battered
Child Syndrome has been judicially recognized as an acceptable medical
Best Interest of the Child A standard frequently used by
child welfare agencies and child welfare courts in determining whether to
undertake specific acts regarding a child.
Birth Parent A parent to whom a child is born. Also called
biological or natural parent.
Blunt Force Trauma Injury caused by force from a blunt
object (such objects may include hands and feet).
Includes abrasions, bruises and contusions, and lacerations.
Board Certified A physician
who has completed residency training and has passed an official medical board
approved examination to be listed as a specialist in a particular field.
Bone Scan A nuclear medicine study that can assist in
diagnosis of early or minimal fractures, especially in children under two years
of age where bones have not ossified.
Brain Stem Portion of the brain connecting the cerebrum and
the cerebellum to the spinal cord.
Bruise An injury that does not break
the skin but causes ruptures of the small underlying vessels with resultant
discoloration of tissues. Organs can also be bruised, e. g. , brain, kidneys.
See also Hemorrhage.
Burn A wound resulting from the application of heat, cold,
electricity, or chemicals to the body. Burns are classified in terms of the
degree of damage.
Petechiae Very small bruises caused by broken capillaries.
Purpura Petechiae occurring in groups or a small bruise up to one centimeter
Ecchymosis Bruise larger than one centimeter in diameter.
First Degree Injury limited to the epidermis (outer skin layer).
Second Degree Injury through the epidermis and dermis, typically causing the
formation of blisters.
Third Degree Destruction of the entire skin, including nerve fibers.
Calcification Process in which
organic tissue becomes hardened by the deposition of lime salts in the tissues,
e.g., the formation of bone. Seen through x-rays, the amount of calcium
deposited indicates the degree of healing of a broken bone or the location of
previous healed fractures.
Callus The hard bone-like substance that forms around the
site of fractured bones and gradually fuses with underlying bone as the
fracture heals. It is visible on x-ray about a week after the injury.
Calvaria (Calvarium) The upper dome-like portion of the
skull, composed of the superior portions of the frontal, parietal, and
CAPTA See Child Abuse Prevention and Treatment Act.
Caretaker In child welfare, a person responsible for a
childs health or welfare. This may be the childs parent or guardian, another
person within the childs own home, or relative in a relatives home, foster
care home, or residential institution.
Cartilage Hard connective tissue that is not bone. In the
fetus and growing child, cartilage may be the forerunner of bone before calcium
is deposited to form bone.
Case In child welfare, refers to both to the process of a
child and family through the child welfare agency and to the process of the
child and family through court.
Case Management A systemic approach to social work in which
an emphasis is placed on the system in which a client must function rather than
on inner thought process. Case management requires identification and
coordination of the multiple services required by the client.
Case Plan In child welfare, a written document which
contains at least: (1) a description of the home or institution in which the
child is placed; (2) a plan for assuring that the child receives proper care
and that services are provided which will reduce risk, promote healthy family
functioning or facilitate the childs return home or to another permanent
placement; and (3) the childs health and education records.
Case Planning The continuous process engaged in by a child
welfare agency in developing and modifying a child or familys case plan.
Case Worker The staff member of a child welfare agency who
is responsible for working with a child or family.
C.A.T. Scan (Computerized Axial Tomography) a radiological
study using x-rays translated by computer to show body cross sections.
Cause of Death The effect or condition that
brought about the cessation of life (e.g., trauma, asphyxia, cancer).
Cellulitus Inflammation of cellular or
Central Registry In child welfare, generally, a listing of
names of persons found by a CPS agency to be perpetrators of child abuse or
neglect. The existence and use of Central Registries varies from state to
Cerebral Pertaining to the brain.
Cerebral Edema Swelling of the brain due to accumulation of
Child Person under 18 years of age.
Child Abuse (Common, legal)
Intentional injury to a child. Each state has enacted its own definition of
child abuse, generally based on the definition found in the federal Child Abuse
Prevention and Treatment Act. According to the Child Abuse Prevention and
Treatment Act (see CAPTA) is any recent act or failure to act on the part of a
parent or caretaker which results in death, serious physical or emotional harm,
sexual abuse or exploitation; or an act or failure to act which presents an
imminent risk of serious harm.
Child Sexual Abuse The
employment, use, persuasion, inducement, enticement, or coercion of any child
to engage in, or assist any other person to engage in, any sexually explicit
conduct or simulation of such conduct for the purpose of producing a visual
depiction of such conduct; or the rape, and in cases of caretaker or
inter-familial relationships, statutory rape, molestation, prostitution, or
other form of sexual exploitation of children, or incest with children. Note:
Each state is responsible for providing its own definition of child abuse and
Child Abuse Central Index A state central index of reports
of child abuse/neglect; it generally includes acts or omissions by caretakers
that are held to be true and of significance after an investigation by law
enforcement or child protective services (CPS).
Child Abuse Prevention and Treatment Act (CAPTA) An act
introduced and promoted in Congress by the US Senator Walter Mondale and signed
into law on January 31, 1974. The Act emphasized multidisciplinary approaches
to child abuse and neglect. Codified at 42 USC § 101 et seq.
Child Abuse Protocol Committee County level representatives
from the office of the sheriff, county department of family and child Services,
office of the district attorney, juvenile court, magistrate court, county board
of education, office of the chief of police of the largest municipality in the
county, and the office of the coroner or medical examiner. The committee is
charged with developing local protocol to investigate and prosecute alleged
cases of child abuse. See Local Child
Death Review Team.
Child Death Review Report A standardized form required for
collecting data on child fatalities meeting the criteria for review by the
Child Death Review Teams as approved by the relevant jurisdiction.
Child Death Review Team (CDRT)
Representatives from the office of the coroner or medical examiner, county
department of family and children services, public health department, juvenile
court, office of the district attorney, and law enforcement. May be formed at a
county, regional or state level.
Child Development Pattern of sequential stages or
interrelated physical, psychological, and social development in the process of
maturation from infancy and total dependence to adulthood and relative
Child Maltreatment See Child Abuse.
Child Neglect (Common, legal) An
injury to a child caused by the omission of necessary acts including failure to
provide food, healthcare, shelter or safety. See Child Abuse.
Child Protective Services (CPS) (Common) The welfare
department/social service system designed to protect children. In most states,
the entity that receives and investigates reports of suspected child
maltreatment and provides services to children and families to ameliorate past
maltreatment and prevent future maltreatment.
Child Welfare Agency In most states, the public agency
responsible for the provision of services such as Child Protective Services
(CPS) and foster care.
Child Welfare and
Adoption Assistance Act (Public Law 96-272) A federal law passed
in 1980 intended to prevent multiple foster care placements and increase
effective permanency planning for children in foster care. Case plans, findings
of reasonable effort, periodic reviews, and dispositional reviews are among its
requirements for states wanting a share of money appropriated under the Act.
Child Welfare Court The court that hears child welfare cases
(emergency removal, adjudication, disposition, review, termination or parental
rights). Sates have different names for this court, including family court,
juvenile court, and dependency court.
Choking When the upper airways is blocked by a foreign
Chronic In medicine, developing slowly and persisting for a
long period of time.
Citizens Review Board See Foster
Care Review Board.
Civil Court Courts established for the adjudication or
controversies between individual parties, or the ascertainment, enforcement,
and redress of private rights. The court which hears child welfare cases is a
Clotting Factor Material in blood that causes it to
coagulate or clot. Deficiencies in clotting factors can cause profuse internal
bleeding and bruising, as in the disease hemophilia. Bruises or bleeding caused
by clotting factor deficiencies may be mistaken for abuse.
Coagulation The process of clotting. The bodys process of
healing itself when blood is released from an injured vessel.
Coagulation Studies Blood tests done to diagnose or rule out
possible clotting factors diseases.
Coining A Southeast Asian folk remedy in which the edge of a
coin is repeatedly rubbed over the body, generally the upper torso, windpipe
and inner arm. The result is a series of reddish to purple vertical bruises
resembling strap marks, which vary in depth and severity. The bruises are
believed to be an indicator for the evil spirits of a disease to exit the body.
Colon The part of the large intestine that connects the
small bowel (ileum) with the rectum.
Colposcope Optical instrument for low power magnification of
the external genitalia as well as the vagina and cervix. Used for detection of
sexual injuries. Also used for detection of ano-rectal injuries.
Commissioner See Master.
Common Law In the law, the system of jurisprudence (the form
of law) which developed in England and came to American colonies during
colonization. Common law is derived and developed from the decisions of judges.
Completed Review Data entered and verified in a Child Death
Review Data System.
Competent Intent The desire
to cause an event to happen by someone with the ability to form that intent
(some say a child under the age of 8 does not have the ability to form
Concussion An injury to the brain caused by a violent
jarring or shaking, or a blow to the brain. After a mild concussion there may
be a brief loss of consciousness with a headache on awakening. A severe
concussion may cause lengthy unconsciousness and disruption of breathing or
other vital functions of the brainstem.
Confidentiality Statement A standardized form, approved by
the jurisdictional authority, which must be signed by all participants in the
Congenital Those mental or physical traits, malformations,
disease, etc., that are present at birth. May be hereditary or due to some
influence during gestation.
Consultants Non-statutory members of a Child Death Review
Team chosen to serve on a review team for their expertise, experience, and/or
Contusion See Bruise.
Coroner A jurisdictional official whose duty it is to
investigate sudden, suspicious, or violent death to determine the cause.
Also referred to as medical examiner.
Coroner's Investigator An official investigator for the
coroner, who may have varied backgrounds, levels of education and areas of
Corporal Punishment Physical punishment inflicted directly
upon the body.
Cortex The outer layer of an organ.
Costal Cartilage Cartilage that attaches the ribs to the
sternum or to other cartilage.
Cranium The skull.
Crime Scene The physical site where a crime may have
Criminal Court A court designated to hear matters relating
to criminal law, this court hears cases involving the crime of child abuse.
Crisis Intervention In social work, the purposeful
activities and involvement of a helping a person at the point that another
person or family is caught in acute, disabling distress due to situational
events. The intervention includes rapid response to move the client from
emotional disorganization to rational problem solving through time-limited
counseling and other services.
Cupping A folk remedy in which an alcohol-soaked material is
ignited in a small cup or jar. After the flame is extinguished, the cup is
placed over the skin and the resulting suction forces the tissue into the mouth
of the cup. The cup is left in place for approximately twenty minutes. Cupping
results in a 2-inch circular, unraised, ecchymotic burn. Wounds usually are
produced in symmetrical, vertical rows, in clusters of two and four on the
right and left side of the chest, abdomen, and back, or in smaller groupings on
Custody In law, the right to care and control of a child and
the duty to provide that childs food, clothing, shelter, ordinary medical
care, education, and discipline. Parents are the natural custodians of their
child. However a court may grant temporary custody to someone other than a
parent, pending further action or review by the court.
Cutaneous Pertaining to the skin.
Cyanosis Purplish or bluish discoloration of the skin and
mucous membranes, caused by a lack of oxygen in the blood.
Death The cessation of life, manifested
in people by a loss of heart beat, absence of spontaneous breathing, and the
permanent loss of brain function; loss of life. See Fatality.
Death Certificate Official document noting the cause and
mode of death. See Cause, Mode, and Fetal Death Certificate.
Death Scene Investigation An attempt by a person functioning
in an official capacity to gather information at the site where a fatal
illness, injury, or event occurred, for the purpose of determining the cause
and circumstance of the death.
Defendant In civil proceedings, the
party responding to the complaint brought by the plaintiff. In criminal
proceedings, the person accused of a crime, synonymous with accused.
Dehydration A large loss of fluid from the body tissues. It
may occur after any condition in which there is a rapid loss of body fluids,
including fever, diarrhea, or vomiting. Dehydration is particularly dangerous
in infants and young children.
Dependency Court Specialized civil court designated to hear
matters pertaining to child abuse/neglect. See Criminal Court, Family Court or
Child Welfare Court.
Depression In psychology, a mood disorder in which there are
extreme feelings of helplessness, hopelessness, inadequacy, or sadness.
Dermis Inner layer of skin.
Diaper Rash A skin irritation in the diaper area. Possible
causes include yeast infections, bacterial infections, urinary tract
infections, parasitic infestations, contact irritation from soaps or diaper
wipes, infrequent diaper changes or poor hygiene.
Diaphysis The shaft (long, thin part) of a long bone which
is between two flared ends.
Differential Diagnosis The determination of which two or
more diseases with similar symptoms is the one from which the patient is
suffering. For example, osteogenesis is a differential diagnosis for child
Discipline Behavior that educates and corrects or punishes.
Disposition In Child Protective Services, the finding of the
validity of a report of child maltreatment that is made by the caseworker after
investigation, disposition categories vary from state to state.
Disposition Hearing In child welfare court cases, a court
hearing which determines whether a child needs or requires the courts
assistance, guidance, treatment, or rehabilitation and, if so, the nature of
that assistance, guidance, treatment, or rehabilitation.
Disposition Review In a child welfare court case, a hearing
in which the court reviews the childs case to ensure that a permanency plan is
being implemented in the childs best interest.
Dissociation In psychology, the separation of thought or
feeling from consciousness, e.g., when a sexual abuse victim pulls away from
the cognitive and emotional experience of the abuse. Multiple Personality
Disorder is a severe and rare outcome of dissociation.
Distal The parts of the body, limbs, or organs, that are
farthest from the trunk or point of origin.
Due Process of Law The right of persons under the 5th and
14th Amendments to the U.S. Constitution to procedural and substantive fairness
in situations in which the government would deprive the person of life,
liberty, or property.
Dura Mater The tough fibrous membrane covering the brain and
the spinal cord.
Ecchymosis See Bruise.
Ecological - In the behavioral and social sciences, refers to
the consideration of the interaction of personal, physical, behavioral, social,
cultural, medical, economic, environmental and systemic determinants when
analyzing the behavior of individuals, families, groups and systems.
Edema Swelling caused by an excess of fluid in the body
Eligible Death Death meeting the criteria for review
including death resulting from SIDS, unintentional injuries, intentional
injuries, medical conditions when unattended by a physician, or any manner that
is suspicious or unusual.
Emergency Medical Services The complete chain of human
physical resources that provide patient care in cases of sudden illness or
Emergency Medical Technician (EMT) A professional provider
of emergency care. An EMT receives formal training and certification. There are
three levels of emergency medical technicians.
Emergency Removal Hearing
An immediate hearing held by the child welfare court which determines whether
to continue emergency out-of-home placement for an allegedly maltreated child.
State laws vary on the time by which the hearing must be held after the child
has been removed from the home in an emergency. Synonymous with shelter
EMT Basic Can administer oxygen and initiate defibrillation but is not
allowed to perform any type of invasive care.
EMT Intermediate Has passed specific training programs in order to provide
some level of advanced life support, for example, the initiation of intravenous
lines and administration of some medications. In some states this level is
currently being phased out.
EMT Paramedic Has successfully completed
paramedic training and has received appropriate certification. EMT paramedics
can generally perform relatively invasive field care including insertion of
endotracheal tubes, initiation of intravenous lines, administration of
medications, interpretation of electrocardiograms, and cardiac defibrillation.
Emotional Maltreatment Passive or active patterned,
nonnurturing behavior by a parent or caretaker that negatively affects or
handicaps a child emotionally, psychologically, physically, intellectually,
socially, or developmentally. The definition can vary by state.
Encopresis Uncontrolled or involuntary bowel movements.
Enuresis Uncontrolled or involuntary passage or urine.
Environmental Pertaining to all of the many factors that
affect the life of a person, including physical and psychological.
Epidemiology The study of the spread, prevention, and
control of disease in a community or a group of persons.
Epidermis The outer most skin layer.
Epiphysis The rounded ends of a long bone.
Evidence In law, something that makes another thing evident
or tends to prove that a fact at issue is true.
Examination In law, the questioning of a witness.
Circumstantial Evidence of a fact from which another fact can reasonably be
Direct Evidence which is presented in the testimony of a witness who has
direct knowledge of the fact being proved.
Hearsay An out of court statement intended to prove the truth of the matter
being asserted. Hearsay evidence is usually excluded from court proceedings
because it is considered unreliable and because the person making the original
statement cannot be cross-examined.
Opinion Witnesses are ordinarily not permitted to testify as to their
personal beliefs or opinions, being restricted instead to reporting what they
actually saw or heard. However, a witness can give an opinion if qualified as
an expert. See Expert Witness.
Physical Any tangible piece of proof. Physical evidence usually must be
authenticated by a witness who testifies to the connection of the evidence
(called an exhibit) with other facts of the case.
Prima Facie Evidence that will suffice as proof of the fact in issue until
its effect is overcome by other evidence.
Expert Witness Someone the court determines to have
expertise on a subject (does not necessarily require any graduate degree). The
witness may qualify as an expert through experience, training, or education.
Only an expert witness may testify in the form of opinion.
Expungement Destruction of records. In law, expungement may
be ordered by a court after a specified number of years or when the juvenile,
parent, or defendant applies for expungement and shows that his/her conduct has
improved. In child welfare, expungement also means the removal from the Central
Registry of certain reports of abuse or neglect.
Extremity Portion of the body that is not a part of the
trunk (e.g., arms, legs).
Failure to Thrive A medical condition seen in young children
where a child does not gain weight. It may be associated with a decrease in the
rate of growth or in a growth rate that is significantly below norm. The cause
may be organic (natural) or non-organic, such as poor nutrition, inadequate
food intake, or inappropriate formula preparation.
Family Court Court designated to hear matters pertaining to
family law (e.g., divorce and child custody). See Child
Family Dynamics Interrelationships between and among
individual family members. The evaluation of family dynamics is an important
factor in the identification, diagnosis, and treatment of child abuse and
Family Dysfunction Ineffective functioning of the family as
a unit or of individual family members in their family roles because of the
physical, mental, or situational problems of one or more family members.
Family Preservation Services Services provided which support
the principle that a child should be maintained in the family if the childs
safety can be ensured.
Family Reunification Services Services which support the
principle that the preferred permanency plan for a child in foster care is the
return to the family if the childs safety can be ensured.
Fatality Loss of life. See
Felony Generally, any criminal offence for which the penalty
is imprisonment for more than one year. Murder, rape, and armed robbery are
crimes usually considered felonies.
Felony Murder See Homicide.
Fetal Alcohol Syndrome A congenital syndrome caused by
intrauterine exposure to alcohol. Characteristics include intra and
axtrauterine growth retardation, microcephaly (small head), and mental
Fetal Death (Common) Death of pregnancy after approximately
Fetal Death Certificate Official document noting the death
of a fetus (note does not include a space for mode of death.) See
Mode of Death.
Fetal Homicide (Legal) The death of a viable fetus caused by
competent intent. See Viable Fetus.
Fingering See Spooning.
Fontanelle (Fontanel) The two soft areas (soft spots) on
the head of an infant where the bones are not yet joined. One soft spot
disappears at about two months and the other at about eighteen months of age. A
bulging fontanelle may indicate increased pressure in the skull.
Forensic Having to do with the study of criminal acts.
Forensic Pathologist A pathologist
with training in criminal pathology. See Board Certified.
Form 1 A standardized form required for collecting data on
all child fatalities by coroners or medical examiners.
Foster Care Placement for children under dependency court
jurisdiction (note this includes single family homes, group homes with no more
than six children, or institutions with many children). Includes continuous
24-hour care and supportive services provided for a child while the child needs
substitute care outside of the childs family.
Foster Care Review Board (Citizens
Review Board) A volunteer panel of citizens that reviews the
cases of children who have been in foster care under public agency for at least
six months. Boards generally seek to determine the efforts that have been made
to achieve permanent and stable placements for foster children and to encourage
and facilitate the implementation of permanency plans in their best interest.
Foster Care Services In most states, the entity that
provides services to children and families when a child is in foster care.
Foster Family Home A type of foster care that is provided in
a family setting.
Fracture Any break of crack in bone or cartilage.
Basilar Skull A fracture to the base of the skull which will often result in
spinal fluid leaking from the nose or ear.
Bucket Handle Tears Total fracture of a long bone so that it is floating
Chip A small piece of bone is separated from the main body of the bone;
Comminuted A bone broken into a number of pieces.
Compound A broken bone that protrudes through the skin.
Egg Shell A fracture of the skull that looks like a broken egg on an x-ray.
Greenstick The bone is bent and there is an incomplete fracture in the convex
side of the curve. Common among young children.
Incomplete The line of the fracture does not include the entire bone.
Occult A fracture that is not visible on x-ray.
Pathologic A fracture occurring at a site weakened by a preexisting disease,
as seen in osteogenesis imperfecta, tumors, or Gauchers Disease.
Simple A break in a bone without displacement of the bone pieces.
Spiral A break in a long bone which is spiral shape, resulting from twisting
of the extremity.
Gauchers Disease A rare, familial disease in infants, which
may cause fractures. Gauchers Disease is a differential diagnosis for child
Gluteal Referring to the buttock.
Good Cause Removal A cause which bears a reasonable
relationship to an individuals unfitness to discharge the duties assigned or
is in a reasonable sense detrimental to the interest or purpose to the Child
Death Review Team.
Gross Examination In medicine, a physical examination
without the aid of radiologic instruments or surgical entry.
Group Home A type of foster care in which care is provided
in a small group setting.
Guardian An adult who is legally responsible for a child. A
guardian has almost all the rights and powers of a parent, but the legal
relationship is subject to termination and change. A guardian may also have
physical custody of the child.
Guardian ad litem A lawyer or non-lawyer who represents the
best interest of a child in a child welfare court proceeding.
Hematemesis Vomiting of bright red blood, often resulting
from internal injury.
Hematoma Swelling caused by the accumulation of blood in the body
Hematuria Blood in the urine.
Intramural of the Duodenum A hematoma occurring in the wall of the duodenum.
Occurs only from trauma.
Hemophilia An inherited disorder of the blood in which there
is a defect in its ability to clot, resulting in a tendency to hemorrhage.
Hemostasis Screen A laboratory study pefomred to determine
whether or not a child has a bleeding or bruising tendency.
Intra-abdominal bleeding within the abdomen.
Intracerebral Bleeding within the brain.
Intracranial Bleeding within the skull.
Intradermal Bleeding within the skin. See Bruise.
Retinal Bleeding into the inner lining of the eye,
hallmark of whiplash and Shaken Baby Syndrome.
Hepatic Pertaining to the liver.
Homicide (official) Death caused by another with the intent
to kill or severely injure.
Homicide (common but not official)
Death at the hands of another (without reference to intent).
Murder The unlawful killing of a human being with malice aforethought. Malice
aforethought requires premeditated intent plus an element of hatred.
Felony Murder The unintentional killing of a human being during the
commission of a felony.
Manslaughter An unlawful killing of a human being without malice
Voluntary Manslaughter An intentional killing committed under circumstances
which, although they do not justify the homicide, mitigate it.
Involuntary Manslaughter Criminally negligent homicide, such as a death
resulting from the negligent operation of a motor vehicle.
Homicide Detective (Investigator) A police or sheriff
department investigator with an expertise in homicide investigations.
Hospital Shopping The use by a person or family of different
medical facilities so that each individual medical facilitys sole contact with
the person or family is a single presenting injury.
Hydrocephalus Water on the Brain, in infants, an
accumulation of fluid in the subarachnoid or subdural spaces of the brain.
Hyperactive More active than normal. The term becomes
synonymous with Attention Deficit Disorder with Hyperactivity (ADDH or ADHD or
ADD), that is characterized by inattention, impulsivity, and hyperactivity.
Hyperemia An excess of blood in a part of the body causing
reddening of the skin; it disappears when pressure is applied.
Hyperpigmentation Increased pigmentation of the skin.
Hyperthermia High body temperature.
Hyphema Hemorrhaging into the anterior chamber of the eye,
often appearing as a bloodshot eye. Blows to the head or violent shaking are
two possible causes. See Hemorrhage-Retinal.
Hypoactive Less active than normal.
Hypothermia Low body temperature.
Hypothalamus The portion of the brain which controls and
integrates functions such as general regulation of water balance, body
temperature, sleep, food intake, and the development of secondary sex
Hypovitaminosis A condition caused by a deficiency of one or
more essential vitamins.
Idealization In psychology, attributing exaggerated positive
qualities to self or other, e.g., a child may idealize an absent or abusive
Identification In psychology, increasing feelings of worth
by identifying oneself with a person or institution of illustrious standing.
Identification with the Aggressor In psychology, a defense
mechanism consisting of imitation of the aggressor.
Impassivity A state of not feeling or showing emotion.
Incest Sexual intercourse between persons who are closely
related by blood. While incest between parent and child or siblings is almost
universally forbidden, various cultures may extend the boundaries to prohibit
intercourse with other relatives. In the U.S., the prohibition against incest
is specified by state laws as well as by cultural tradition. States usually
define incest as marriage or sexual relationships between relatives who are
closer than second, or sometimes even more distant, cousins. While incest and
sexual abuse are often thought to be synonymous, incest is only one type of
Incidence In epidemiology, the extent to which a problem
occurs in a given population.
Independent Living A possible permanency plan for a child in
foster care in which the goal is self-sufficiency after discharge from foster
Indian Child Welfare Act (ICWA) A federal law which
specifies the manner in which child welfare agencies and child welfare courts
must handle cases involving Native American and Alaska Native Children.
Infant Child under one year of age. See Neonate.
Infanticide The killing of an infant or of many infants.
Injury Refers to any force whether it be physical, chemical,
thermal, or electrical that results in harm or death.
Intentional Injury Death
Public health term used to define death caused by another with the intent to
cause harm. See Competent Intent.
Intern Student trainee, also refers to a physicians first
year of work after medical school.
Intent Desire to cause to happen. See
Intraocular Within the eye.
Intravenous Within a vein.
Judgement The courts final decision.
Jurisdiction A courts authority over the subject matter,
the person, and the rendering of a particular order or judgement.
Juvenile Court See Child Welfare
Kinship Care (Relative Placement)
Residential caregiving provided to children by nonparental relatives. Kinship
care may be full-time or part-time, temporary or permanent, and may be
initiated by private family agreement or under the custodial supervision of a
child welfare agency.
Laceration A torn or jagged wound caused causing a splitting
or tearing in the external skin surface in addition to the deep tissue.
Language Delay A situation in which a childs language
abilities are considerably poorer than the abilities of most children of the
Lateral Occurring on, or pertaining to, the side.
Lesion Any injury to any part of the body from any cause
that results in damage or loss of structure or function of the body tissue
involved. A lesion may be caused by poison, infection, dysfunction, or
violence, and may be either intentional or unintentional.
Lethargy A state marked by loss of energy, inactivity,
sluggishness, or excessive drowsiness.
Leukemia A malignant disease of blood forming elements.
Children suffering from leukemia may present petechiae or bleeding which should
be considered in the differential diagnosis of children who bruise easily.
List Serv Computerized one-to-many electronic mail system
that allows individuals to share information with a group.
Local Child Death Review Team
A Child Death Review Team that operates within a specific area within a
state, i.e., county, reservation, or other geographical area. See
Long Bones Bones of the arms (ulna, radius, numerous) and
legs (femur, tibia, fibula).
Malnutrition A condition caused by inadequate nourishment.
Maltreatment See Child Abuse and
Mandated Agency The agency designated by state law to
receive and investigate reports of suspected child abuse and neglect. The
specific agency varies from state to state.
Mandated Reporters Persons designated by state law who are
legally responsible for reporting suspected child abuse and neglect to the
mandated agency within their state. Mandated reporters vary according to state
law, but are primarily professionals, such as doctors, nurses, school
personnel, and social workers who have frequent contact with children and
Mandible The bone of the lower jaw.
Manner of Death The legal classification, whether natural,
suicide, homicide, accidental, or undetermined.
Manslaughter See Homicide.
Master A person appointed by a court in
certain cases to hear testimony and make reports that, if approved by the
court, become the decision of the court. In some states, masters may hear child
welfare court cases. Also referred to as referee or commissioner.
Mechanism of Death The physical reason for a death (e.g.,
head trauma caused brain swelling which caused decreased brain function which
caused the heart and/or lungs to stop functioning).
Medial Towards the middle or mid-line.
Medical Cause Refers to death resulting from a natural cause
other than SIDS.
Medical Examiner An official whose duty it is to investigate
sudden, suspicious, or violent death to determine the cause. See Coroner.
Medical Neglect Generally, the repeated failure of parents
or caretakers to comply with recommendations from medical professionals for the
treatment of a childs condition. Individual states may define the term
Menkes Kinky Hair Syndrome A rare, genetic disorder which
blocks absorption of copper in the gastrointestinal system, causing brittle
bones and eventual death. It is a differential diagnosis for child abuse.
Mesentery Membranes which cover abdominal organs and attach
the bowel to the abdominal wall. The mesentery may be injured in interabdominal
trauma or inflames, as with peritonitis.
Metaphysis The area of bone between the epiphyses
(extremities) and diaphysis (shaft) which flares out at the end of long bones.
It contains the growth zone of the bone.
Minor See Child.
Misdemeanor Criminal offenses that are less severe than
felonies and generally punished by lesser fines or by jail terms which do not
exceed a year.
Mode or Manner of Death Official
category for a death certificate (homicide, suicide, undetermined, accidental,
Mongolian Spot A type of birthmark that appears most
frequently on a childs lower back or buttocks. These dark pigmented areas
usually fade by age five. They are sometimes confused with bruises.
In child welfare, a group of professionals representing various disciplines who
meet to coordinate their efforts in diagnosing and treating specific cases of
child abuse and neglect. A multidisciplinary team may also address the general
problem of child abuse and neglect in their community. See
Local Child Death Review Team.
Munchausen Syndrome by Proxy A pattern of abuse in which the
perpetrator, usually a parent, will fabricate medical histories, inflict
physical findings, alter laboratory specimens and induce disorders in a child
to give the appearance that the child is ill.
Murder See Homicide.
National Crime Information Center (NCIC) Criminal justice
information systems operated by the Federal Bureau of Investigation in
Natural Cause Death resulting from inherent, existing
conditions. Natural causes include congenital anomalies, disease, other medical
causes, and SIDS.
Neglect See Child
Negligence In the law, doing something that a person of
ordinary prudence would not do, or the failure to do something that a person of
ordinary prudence would do, under given circumstances.
Neonate Infant under one month of age.
Neurologic Sequelae A diseased condition of the nervous
system resulting from previous disease. In abused children, the condition may
result from previous abuse.
Non-Intentional Injury Death
Public health term to replace accidental death.
Occipital Back of the head.
Ossification The process during which immature or new bone
or cartilage is converted into bone.
Osteogenesis Imperfecta A genetic condition which causes
bone to be brittle and prone to fracture. It is a differential diagnosis for
Osteomyelitis Inflammation of bone caused by a bacterial
Paralysis Complete or partial loss of functioning, usually
involving motor function in a part of the body.
Paramedic See EMT-Paramedic .
Parens Patriae Parent of the country. Refers to the role
of the state as sovereign and the guardian of persons under legal disability.
It is through parens patriae that the state investigates possible child abuse
and neglect, and places a child in foster care.
Passive In psychology, not reacting visibly to something
that might be expected to produce manifestations of an emotion or feeling.
Pathognomonic Specifically distinctive or characteristic of
a disease or pathologic condition; a sign or symptom on which a diagnosis can
Pathologist Physician with residency training in pathology.
See Forensic Pathologist and
Pediatrician Physician who has completed residency training
Physician with special training in pediatrics and pathology. See
Perinatal The period of time from around the twenty-eighth
week of gestation through the first seven days after delivery.
Perineum Region of the body between the anus and the genitals.
Periodic Review In child welfare, the six-month review of cases of
children in out-of home care required by Public Law 96-272 and state law.
Periosteal Elevation (Hemorrhage) The tearing away or lifting up of
the bone's covering, from the hemorrhaging that occurs when a bone is broken or
there has been bleeding under the periosteum. This is not necessarily
indicative of child abuse as it can be due to leukemia or infiltrative disease
such as tumors or inflammation. It may be present at birth from a difficult
Periosteum The outer covering of bones that is essential for bone
formation and healing.
Peritoneum The lining of the abdomen.
Peritonitis Inflammation of the membranous lining of the abdominal
Perjury Knowingly and willfully giving false testimony under oath.
Permanency Plan In child welfare, a plan for implementing the most
permanent long-term living situation possible for a child, consistent with the
childs best interest. This plan specifies where and with whom a foster care
child shall live, and the proposed legal relationship between the child and the
permanent caretaker or caretakers.
Permanency Planning The process by which a welfare agency
with responsibility for the child in foster care develops a permanency plan for
Perpetrator In child welfare, a person(s) who committed an
act that resulted in the death of a child.
Petechiae See Hemorrhage
Petition In the law, a formal, written request to the court
that it do something. The petition is a pleading that begins a court case. It
contains the facts and circumstances upon which a court is asked to provide
certain relief as well as the relief being sought.
Physical Abuse See Child Abuse.
Pia Mater The fine vascular membrane that envelopes the
brain and spinal cord.
It is located below the arachnoid and the dura mater.
Plaintiff In a civil case, the person who files a lawsuit.
Pleadings In the law, formal allegations of the claim and
defenses raised by the parties to the court case.
Posterior In human anatomy, the back surface of the body.
Postpartum Depression Depression which may occur after child
Premature Infant An infant born after thirty-seven weeks
gestation by before full term and, arbitrarily, an infant weighing 2.2 - 2.5
pounds at birth. This definition varies.
Prenatal Occurring before birth.
Preventable Death A childs death is considered to be
preventable if the community (through legislation, education, etc. ) or an
individual (through reasonable precaution, supervision, or action) could have
done that which could have changed the circumstances that led to the death.
Prevention In public health, the keeping of something (such
as an illness) from happening. There are three general levels of care designed
Probable Cause In the law, a requisite element of a valid
search and seizure or of an arrest, which consists of the existence of facts
and circumstances within ones knowledge that are sufficient to warrant the
belief that a crime has been committed (in the context of an arrest) or that
property subject to seizure is at a designated location (in the context of a
search and seizure). Whether probable cause exists depends of the independent
judgement of a detached magistrate.
Primary The first level of care, designed to prevent the occurrence of
disease and promote health.
Secondary The second level of care, based on the earliest possible
identification of disease so that it can be more readily treated or managed and
adverse sequelae can be prevented.
Tertiary The third level of care, concerned with promotion of independent
function and prevention of further disease-related deterioration.
Prosecution The act of pursuing a lawsuit or criminal trial;
also, the party initiating a criminal suit.
Proximal Those parts of the body, or portions of the bone,
that are closest to the trunk or to the point of origin.
Psychosis In psychology, a mental disorder causing gross
impairment of a persons mental capacity, affecting response and capacity to
Public Law 96-272 See
Child Welfare and Adoption Assistance Act.
Purpura See Hemorrhage
Radiolucent In medicine, a part of a body or object which
permits the passage of x-rays without leaving a shadow on the film. Soft
tissues are radiolucent, bones are not.
Rarefaction Loss of density; on an x-ray, an area of bone
which appears lighter than normal is in a state of rarefaction indicating a
loss of calcium.
Rationalization In psychology, attempting to prove that
ones behavior is rational and justifiable, and thus worthy of self and
Reaction Formation In psychology, the substitution of
behavior, thoughts, or feelings which are diametrically opposed to the persons
own unacceptable ones. For example, a parent feels guilty about lack of bonding
with the child and instead overindulges the child.
Reasonable Effort In child welfare, the ordinary diligence
and care by a child welfare agency to identify child protection problems and
provide services to solve those problems so as to prevent out-of-home placement
or promote family reunification.
Reconsideration In child welfare, the process of
periodically reassessing and redeveloping the permanency and case plans.
Records Request Form Standardized forms, which generally are
state approved, for requesting records on individual cases.
Recurrent Otitis Media Repeated inflammation of the middle
ear. It is the leading cause of hearing loss in children.
Referee See Master.
Regression In psychology, retreating to an earlier
developmental level involving less mature responses and, usually, a lower level
Regulation For a governmental agency, directions for the
operation of the agency, developed by the agency to implement its statutory
responsibilities. Regulations have the force and effect of law when issued
following notice to the public and an opportunity for the public comment.
Relative Placement See Kinship Care.
Repression In psychology, a defense mechanism in which the
person is unable to remember disturbing feelings, thoughts, or experiences.
Resident In medicine, a post-intern trainee in an official
training program (e.g., pediatrics).
Retinal hemorrhage Bleeding in the retina of the eye.
Reviewable Death Death which has been reported as having met
criteria for review by the Child Death Review Team, whether or not the review
has yet been completed and reported.
Reviewed Death Death which has been reviewed by a local
Child Death Review Team; a report completed and submitted to the State Child
Death Review Team.
Rickets Condition of delaying maturation of the bones caused
by a Vitamin D deficiency. May be seen with severe malnutrition,
hypoparathyroidism, and renal disease.
Risk Assessment A structured gathering and evaluation of
information related to factors in a childs family, home environment,
temperament, and conditions, to determine the presence, level, and type of
risk(s) to the childs current and future safety and welfare. As relevant
factors change, risk assessment must therefore be conducted over the life of a
Risk Factors Refers to a person, thing, event, etc., that
put an individual at an increased likelihood of incurring injury, disability or
Rubella An infectious viral disease with particular effects
on fetuses (possibly causing abnormalities) or newborn infants. One of the
early manifestations may be petechiae or easy bruising. There also may be
associated bone lesions that may be confused with child abuse.
Rupture The break of an organ or other soft part.
Sacral Area Lower part of the back.
Scapula The flat, triangular bone in the back of the
shoulder; the shoulder blade.
Scar The dense, fibrous tissue that is left behind by the
healing of injured tissue.
Sclera The rough white outer layer of the eyeball.
Search Warrant An order issued by a judge and directing
certain law enforcement officers to conduct a search of specified premises for
specified things or persons, and to bring them before the court. Use of a
search warrant is required by the Fourth and Fourteenth Amendment to the U.S.
Secondary Infection Infection by a microorganism following
an infection by another microorganism.
Seizure Involuntary muscular contraction and relaxation
originating from the short circuit of the central nervous system. Seizures
vary in pattern, length, and intensity. Causes include fever, tumors, injuries,
Sequelae The aftereffects of an injury or disease process.
In child abuse, this term usually refers to the psychological or physical
outcomes which result from being abused or neglected.
Serology The study of blood serum for evidence of infection.
Sexual Abuse See Child Sexual
Sexually Transmitted Disease
(Infection) (STD or STI) Disease transmitted by sexual contact,
including chlamydia, trichomonas, gonorrhea, syphilis, hepatitis B, and HIV.
The presence of a STD in a child is an indicator of possible sexual abuse.
However some STDs are passed on to the fetus during pregnancy or at birth.
Shaken Baby Syndrome
Characterization of head injuries to a young child caused by shaking without
impact. Injury to an infant or child resulting from violent, repetitive
shaking. Pathognomonic findings include intracranial hemorrhaging, retinal
hemorrhaging, and no cutaneous manifestations of injury. Survivors are
frequently left with profound neurologic sequelae, e.g., blindness, deafness,
mental retardation, cerebral palsy, and seizures.
Shaken Impact Syndrome Characterization of head injuries to
a young child occurring with both shaking and impact. Different from Shaken
Baby Syndrome which does not include impact.
Shelter Hearing See Emergency
Skeletal Series of X-rays Defined series of x rays designed
to find most fractures. See Baby Gram.
Skeletal Survey A series of x-rays taken of all the bones of
Smothering Specifically refers to asphyxiation of the nose
and mouth usually by a hand or soft object. Mechanical asphyxia resulting from
external pressure on the body preventing chest movement and breathing.
Social Isolation The limited interaction and contact of many
abusing or neglecting parents with relatives, neighbors, friends, or community
resources. Social isolation can perpetuate a basic lack of trust, which hinders
both the identification and the treatment of child abuse and neglect.
Somatization In psychology, a pathology in which a person
becomes preoccupied with physical symptoms disproportionate to any actual
physical disturbance. May be seen in victims of sexual abuse.
Splitting In psychology, a defense mechanism in which a
person views self and others as all good or all bad, failing to integrate the
positive and the negative qualities of self and others into cohesive images.
Often the person alternately idealizes and devalues the same person.
Spooning (Fingering) A folk remedy
from Southeast Asia for pain relief. The middle knuckle of the index finger or
a spoon is firmly rubbed along the surface of the skin in any area of an ill
persons body, especially along the spine, behind the knees, in the bend of
both arms, and on the chest from just above the nipple to mid-clavicle. If a
raised line appears, no further treatment it necessary.
Standard of Proof An amount of probability necessary for
court to render a decision regarding the evidence presented to it. There are
three different standards of proof.
State Child Death Review Team An appointed body of
representatives that oversees the local child death review process, reports to
the governor annually on the incidence of child fatalities, and recommends
prevention measures based on the data. See Child
Death Review Team.
Beyond a Reasonable Doubt The amount of probability required to find a
criminal defendant guilty. The proof must be so conclusive and complete that
the ordinary person could not reasonably deny it.
Clear and Convincing Evidence An amount of probability less than beyond a
reasonable doubt but more than probable cause. It is used in some civil cases,
including termination of parental rights cases. The proof must produce a firm
belief of truth to the trier of the fact.
Preponderance of Evidence The amount of proof required in most civil cases,
including child welfare cases (except for termination of parental rights
proceedings). The proof must be more likely than not.
Statute A law passed by a legislative body.
Sternum The bone that runs down the front part of the chest;
the breast bone.
Stillborn Potentially viable fetus born dead.
Strangulation Asphyxia caused by external pressure applied
to the neck either by the use of hands or a ligature (rope).
Subarachnoid Bleeding Bleeding that occurs between the pia
and the arachnoid membrane of the central nervous system.
Subcutaneous Beneath the skin.
Subdural hematoma Bleeding between the internal lining of
the skull and the brain.
Subgaleal The inner lining of the scalp. A site of
hemorrhage frequently secondary to hair pulling.
Subpoena In the law, a command to appear at a certain time
and place, on a certain date, and the give testimony on a certain matter.
Sudden Infant Death Syndrome (SIDS) Sudden death of an
infant which is unexpected by clinical history review, death scene
investigation and in which a thorough postmortem examination, including
autopsy, fails to demonstrate an adequate cause. A diagnosis of exclusion made
when there is no underlying cause of death can be identified. It is not caused
by abuse or neglect.
Suffocation Asphyxia caused by a general deprivation of
oxygen either from obstruction of external airways or lack of breathable gas in
Suicide Death of self caused with intent. See Intent.
Summons In the law, a document used to commence a civil
action or special processing. A summons is issued by a court to the sheriff (or
other designated official), requiring them to notify the person named that an
action has been commenced against the person and that the person is required to
appear on a day named and answer the complaint.
Syndrome A group of signs and symptoms that occur together
and are typical of a particular disorder or disease.
Termination of Parental Rights (TPR) A legal process that
severs the legal relationship between parents and the child and vests authority
in the child welfare agency. The TPR order places the child in the guardianship
of the child welfare agency and gives the agency the right to consent to
adoption or long-term care short of adoption.
Testimony Evidence given by a competent witness under oath
or affirmation, as distinguished from evidence derived from written or other
Thorax Chest area, encompassing the heart, lungs, and ribs.
Torsion Twisting, as of a limb.
Traction Drawing or pulling, as in setting a bone.
Trauma An injury or wound brought about by an outside force.
Trauma may be caused unintentionally, or, as in physical abuse, intentionally.
Trauma also refers to physiological discomfort or symptoms resulting from an
emotional shock or painful experience.
Trend In child death surveillance, refers to the changes
occurring in the number and distribution of child deaths.
Undetermined Death Death where the mode of death is not
clear. See Mode of Death.
Unsupervised Death Death which data suggests that the
decedent may not have had adequate supervision at the time of the fatal injury
or death event. Defining variables include reports that the event was
unwitnessed, that the caretaker was asleep at the time (except under normal
sleeping hours), or that there was no adult caretaker present.
Unintentional Death Refers to the act that resulted in death
being one that was not deliberate, willful, or planned.
Vascular Pertaining to or containing blood vessels.
Venereal Disease See Sexually
Venue Related to the locality of the court or courts which
Vertical Team Prosecution A prosecution in which every
member of the prosecution team is the same throughout the trial.
Vesicle Blisters containing fluid.
Viable Fetus A fetus that would
be able to live outside the uterus if born as defined by experts.
Victims of Crime Fund Money available to serve crime victims
through a federal and/or state program with local officials having
responsibility for distribution of funds.
Visceral Pertaining to the internal organs.
Vital Signs Blood pressure, heart rate, respiratory rate,
Vitreous The material that encloses the major portion of the
eye, which is normally clear. With an eye injury there may be hemorrhaging and
the area may turn red.
Welt Minor damage to the skin or to the blood vessels
directly underneath the skin caused by a blow or a cut. Does not involve
Whiplash See Shaken Baby
Witness A person who has first-hand knowledge of the
illness/injury/event leading to injury, disability or death. This excludes
information obtained from other persons. A person inflicting injury on a child
or identified as a perpetrator is not considered a witness. The witness may or
may not be in charge or providing immediate care for the child and may or may
not have custody of the child. First-hand knowledge usually includes seeing or
hearing the illness/injury/event occur.
Wound Pattern Wounds that are close together, similar size
and shape, and inflicted in the same area of the body.
Common Agency Acronyms
CPS Child Protective Services
CDRT Child Death Review Team
CR Central Registry
DES Department of Economic Security
DHS Department of Health Services
DOJ Department of Justice
DPH Department of Public Health
DSS Department of Social Services
DSW Department of Social Welfare
Common Legal Acronyms
CAPTA Child Abuse Prevention and Treatment Act
CWAAA Child Welfare and Adoption Assistance Act (Public Law 96-272)
ICWA Indian Child Welfare Act
NCIC National Crime Information Center
TPR Termination of Parental Rights
VCF Victims Crime Fund