This toolkit is created in effort to Globally aide Child and Abuse Victims, Law Enforcement, Social and Community Professionals and Paraprofessionals , Care Givers, Policy Level Staff in Government or Non-Governmental Organizations, and Trainers  as intervention, Prevention, Educate and Resource Assist others.



Child abuse and neglect are common sources of morbidity and mortality in childhood with devastating consequences.

• One out of every fifty-eight children in the United States (US) is a victim of child abuse or neglect affecting over one million children each year, resulting in irreversible and
pervasive damage to our society.

• Child maltreatment is the leading cause of trauma-related death in children under four
years of age accounting for 80% of all child abuse fatalities.

• In Federal Fiscal Year 2011, 3.4 million referrals were made to Child Protection agencies
nationally. Neglect cases represented over 78% of these referrals.

• Annually, the Department of Children and Family Services (DCFS) Child Abuse
Hotlines receives thousands of calls.

• Unfortunately, the discovery of abuse is often made too late, with over 1,700 deaths,
18,000 permanent injuries, and 150,000 serious injuries occurring each year at an annual estimated direct and indirect cost of over $220 billion in the US. Whereas child abuse is perceived as more prevalent, neglect is actually the leading form of child maltreatment. More children die from neglect than from other physical abuse. Although neglect is the most common, it is the least understood with regard to identification and intervention. Morbidity and mortality results from failure to recognize early signs of child abuse and neglect. Up to
75% of abuse may be missed in acute care settings because signs are not recognized.7 When abuse is missed, repeat injury occurs in up to 80% of victims with mortality rates as high as 30%.

Recent research indicates that many fatal or near-fatal abusive events could have been prevented had early signs of abuse been recognized and action taken.

Typically, children do not present with a chief complaint of “child abuse,” hence the diagnosis can be very elusive. The emergency department (ED) has a formidable role in identifying and treating children with signs and symptoms of child abuse and neglect. As a 24-hour acute care medical system, the ED is often the first site where an injured, neglected or sexually abused child presents or receives referrals from multiple sources (e.g., parents/caregivers, community physicians, child welfare and law enforcement).

Hospitals hold a unique position in their community to promote best practices and
appropriately identify, intervene, document, diagnose, and ensure the child’s safety.

Illinois Emergency Medical Services for Children (EMSC) created this 2nd edition to assist organizations

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