ALLEGATION #

DEFINITION

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Death

Permanent cessation of all vital functions.

The following definitions of death are also commonly used:

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Total irreversible cessation of cerebral function, spontaneous function of the respiratory system, and spontaneous function of the circulatory system.

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The final and irreversible cessation of perceptible heart beat and respiration.

Verification of death must come from a physician or coroner.

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Head Injuries

Head Injury

As used in this Part, head injury means a serious head injury causing skull fracture, brain damage or bleeding on the brain, such as subdural hematoma or shaken baby syndrome.  The following are considered head injuries:

Brain Damage

Brain Damage means injury to the large, soft mass of nerve tissue contained within the cranium skull.

Skull Fracture

Skull Fracture means a broken bone of the skull.

Hematoma

Hematoma means a swelling or mass of blood (usually clotted) confined to an organ, tissue or space and caused by a break in a blood vessel.

Subdural Hematoma

Subdural means beneath the dura mater (the outer membrane covering the spinal cord and brain).

A subdural hematoma is located beneath the membrane covering the brain and is usually the result of head injuries or the shaking of a small child or infant.  It may result in the loss of consciousness, seizures, mental or physical damage, or death.

Shaken Baby Syndrome (Whiplash Shaken Infant Syndrome (WSIS))

Shaking of an infant causes stretching and tearing of blood vessels in the brain causing subdural hematoma, bleeding in the brain and retinal hemorrhage.

Verification of head injuries must come from a physician, preferably a neurosurgeon or radiologist.

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Internal Injuries

An internal injury is an injury which is not visible from the outside, e.g., an injury to the organs occupying the thoracic or abdominal cavities. Such injury may result from a direct blow or a penetrating injury.  A person so injured may be pale, cold, perspiring freely, have an anxious expression, or may seem semicomatose.  Pain is usually intense at first, and may continue or gradually diminish as patient grows worse.

Verification of internal injuries must come from a physician.

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Burns

Burns

Tissue injury resulting from excessive exposure to thermal, chemical, electrical or radioactive agents.  The effects vary according to the type, duration and intensity of the agent and the part of the body involved.  Burns are usually classified as:

– First Degree (Partial Thickness)

Superficial burns, damage being limited to the outer layer of the epidermis (skin).  Characterized by scorching or painful redness of the skin.

– Second Degree (Partial Thickness)

The damage extends through the outer layer of the skin into the inner layers (dermis).  Blistering will be present within 24 hours.

– Third Degree (Full Thickness)

Burns in which both layers of the skin (epidermis and dermis) are destroyed with damage extending into underlying tissues, which may be charred or coagulated.

– Fourth Degree (Full Thickness)

Burns extend beyond skin and underlying tissues into bone, joints and muscles.

Scalding

A burn to the skin or flesh caused by moist heat and hot vapors, as steam.

All emersion burns (scalds) must be confirmed by a physician unless the alleged perpetrator has admitted to scalding the child.

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Poison/Noxious Substances

Poison

Any substance, other than mood altering chemicals or alcohol, taken into the body by ingestion, inhalation, injection, or absorption that interferes with normal physiological functions.  (Virtually any substance can be poisonous if consumed in sufficient quantity; therefore, the term poison more often implies an excessive amount rather than the existence of a specific substance.)

Noxious

Harmful, injurious, not wholesome.

Verification must come from a physician or by a direct admission from the alleged perpetrator.

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Wounds

A gunshot or stabbing injury.

Verification must come from a physician, a law enforcement officer or by a direct admission from the alleged perpetrator.

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Bone Fractures

A fracture is a broken bone.

Metaphyseal – Epiphyseal Fractures

Fractures at the end of bones.  They are commonly described as corner fractures, chipped fractures or bucket-handle fractures.

Diaphyseal Fractures

Diaphyseal fractures are located in the bone shaft.  Fractures in the shaft of long bones of the extremities are spiral (oblique) or transverse.  Spiral fracture is caused by twisting or rotational force.  Transverse fracture results from a direct blow or bending force.

Verification must come from a physician or radiologist.

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Substantial Risk of Physical Injury/Environment

Injurious to Health and Welfare

Substantial risk of physical injury means that the parent, caregiver, immediate family member aged 16 or over, other person residing in the home aged 16 or over, or the parent's paramour has created a real and significant danger of physical injury that would likely cause disfigurement, death, or impairment of physical health or loss or impairment of bodily functions (abuse).  This allegation of harm is to be used when the type or extent of harm is undefined but the total circumstances lead a reasonable person to believe that the child is in substantial risk of physical injury.  This allegation of harm also includes incidents of violence or intimidation directed toward the child that have not yet resulted in injury or impairment but that clearly threaten such injury or impairment (abuse) or placing a child in an environment that is injurious to the child's health and welfare (neglect).

Examples of incidents or circumstances that place the child in substantial risk of physical injury include, but are not limited to, the following:

Incidents of Maltreatment

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choking the child (abuse).

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smothering the child (abuse).

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pulling the child's hair out (abuse).

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violently pushing or shoving the child into fixed or heavy objects (abuse).

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throwing or shaking a smaller child (abuse).

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other violent or intimidating acts directed toward the child that cause excessive pain or fear (abuse).

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situations that place a child at substantial risk of harm due to environmental issues in the home (neglect).

Circumstances

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domestic violence in the home when the child has been threatened and the threat is believable, as evidenced by a past history of violence or uncontrolled behavior (neglect).

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a perpetrator of child abuse who has been court ordered to remain out of the home returns home and has access to the abused child (abuse).

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anyone living in the home has a documented history of violence toward children (abuse).

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the circumstances surrounding the death of one child provides reason to believe that another child is at real and significant danger of physical injury (neglect).

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anyone in the home exposes child to environment that significantly affects the health and safety based on use, sale or manufacturing of illegal drugs or alcohol (neglect).

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parent's or caretaker's mental illness and behavior poses a significant danger to the child's health and safety (neglect).  To indicate an allegation based on this factor, the investigator must rule out dependency as defined in the Juvenile Court Act as the presenting problem.

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parent has been adjudicated unfit by a court and the parent has not completed services that would correct the conditions which led to the court finding (abuse/neglect).

Factors to be Considered

Whether there is a real and significant danger to justify taking a report is determined by the following factors (All factors need not be present to justify taking the report.  One factor alone may present sufficient danger to justify taking the report.):

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the child's age.

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the child's medical condition, behavioral, mental, or emotional problems, developmental disability, or physical handicap, particularly related to his or her ability to protect himself or herself.

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the severity of the occurrence.

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the frequency of the occurrence.

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the alleged perpetrator's physical, mental and/or emotional abilities, particularly related to his or her ability to control his or her actions.

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the dynamics of the relationship between the alleged perpetrator and the child.

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the alleged perpetrator's access to the child.

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the previous history of indicated abuse or neglect.

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the current stresses/crisis in the home.

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the presence of other supporting persons in the home.

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Cuts, Bruises, Welts, Abrasions and Oral Injuries

Cut

An opening, incision or break in the skin made by some external agent.

Bruise

An injury that results in bleeding under the skin, where the skin is discolored but not broken.  Also referred to as a contusion.

Welt

An elevation on the skin produced by a lash, blow, or allergic stimulus.  The skin is not broken and the mark is reversible.

Abrasion

A scraping away of the skin.

Oral Injuries

Injuries to the child's mouth, including broken teeth.

Factors to be Considered

Not every cut, bruise, or welt constitutes an allegation of harm.  The following factors should be considered when determining whether an injury which resulted in cuts, bruises or welts constitute an allegation of harm:

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the child's age (children aged 6 and under are at a much greater risk of harm).

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child's medical condition, behavioral, mental, or emotional problems, developmental disability, or physical handicap, particularly as they relate to the child's ability to seek help.

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pattern or chronicity of similar incidents.

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severity of the cuts, bruises, welts, or abrasions (size, number, depth, extent of discoloration).

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location of the cuts, bruises, welts, or abrasions.

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whether an instrument was used on the child.

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previous history of indicated abuse or neglect.

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Human Bites

A bruise, cut or indentation in the skin caused by seizing, piercing, or cutting the skin with human teeth.

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Sprains/Dislocations

Sprain

Trauma to a joint that causes pain and disability depending upon the degree of injury to ligaments and/or surrounding muscle tissue.  In a severe sprain, ligaments and/or muscle tissue may be completely torn.  The signs are rapid swelling, heat and disability, often discoloration and limitation of function.

Dislocation

The displacement of any part, especially the temporary displacement of a bone from its normal position in a joint.  Types include:

Complicated

A dislocation associated with other major injuries.

Compound

Dislocation in which the joint is exposed to the external air.

Closed

A simple dislocation.

Complete

A dislocation which completely separates the surfaces of a joint.

Verification must come from a physician, registered nurse, licensed practical nurse or by a direct admission from the alleged perpetrator.

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Tying/Close Confinement

Unreasonable restriction of a child's mobility, actions, or physical functioning by tying the child to a fixed (or heavy) object, tying limbs together or forcing the child to remain in a closely confined area which restricts physical movement.  Examples include, but are not limited to:

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locking a child in a closet or small room.

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tying one or more limbs to a bed, chair, or other object, except as authorized by a licensed physician.

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tying a child's hand behind his or her back.

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putting a child in a cage.

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Substance Misuse

Option A

The consumption of a mood altering chemical capable of intoxication to the extent that it harmfully affects the child's health, behavior, motor coordination, judgment, or intellectual capability.  Mood altering chemicals include cannabis (marijuana), hallucinogens, stimulants (including cocaine), sedatives (including alcohol and Valium), narcotics, or inhalants (abuse/neglect).  Abuse occurs if the parent provides the substance to the child.  Neglect occurs if the parent allows the use or fails to protect the child from consumption.

Option B

Fetal alcohol syndrome or drug withdrawal at birth caused by the mother's addiction to drugs is included in this definition and is considered child neglect (neglect).

Option C

Any amount of a controlled substance or a metabolite thereof, found in the blood, urine or meconium (newborn's first stool) of a newborn infant.  A controlled substance is defined in subsection (f) of Section 102 of the Illinois Controlled Substances Act [720 ILCS 570/102] (neglect).  The presence of such substances shall not be considered as child neglect if the presence is due to medical treatment of the mother or infant.

NOTE:

Methadone withdrawal or other withdrawal verified as under the auspices of a drug treatment program is not included under drug withdrawal at birth.

Examples of substance misuse include, but are not limited to:

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giving a minor (unless prescribed by a physician) any amount of heroin, cocaine, morphine, peyote, LSD, PCP, pentazocine, or methaqualone or encouraging, insisting, or permitting a minor's consumption of the above substances.

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giving any mood altering substance, including alcohol or sedatives, unless prescribed by a physician, to an infant or toddler.

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encouraging, insisting or permitting a child who has not reached puberty to consume alcohol, drugs, or another mood altering substance on a regular or frequent basis.

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encouraging, insisting or permitting an adolescent to consume alcohol, drugs, or another mood altering substance on a daily basis.

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encouraging, insisting or permitting any minor to become intoxicated by alcohol, drugs, or another mood altering substance even if on an infrequent basis.

Factors to be Considered

The following factors should be considered when determining whether a child is involved in substance misuse:

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age of the child.

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frequency of substance misuse.

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amount of substance consumption.

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whether the substance is illegal for general population use.

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degree of behavioral dysfunction, or physical impairment linked to substance misuse.

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the child's culture, particularly as it relates to use of alcohol in religious ceremonies or on special occasions.

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whether the parent or caregiver's attempts to control an older child's substance misuse or to seek help for the child's substance misuse were reasonable under the circumstances.

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whether the parent or caregiver knew or should have known of the child's substance misuse.

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Torture

Inflicting or subjecting the child to intense physical and/or mental pain, suffering, or agony that is severe, repetitive, increased, or prolonged.

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Mental and Emotional Impairment

Injury to the intellectual, emotional or psychological development of a child as evidenced by observable and substantial impairment in the child's ability to function within a normal range of performance and behavior, with due regard to his or her culture.

Verification that a child has been mentally injured must come from a medical doctor, psychiatrist, registered psychologist, certified social worker, registered nurse or a therapist or counselor of a community mental health agency.

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Sexually Transmitted Diseases

A disease which was acquired originally as a result of sexual penetration or sexual conduct with an individual who is afflicted with the disease.  The diseases may include, but are not limited to:

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Acquired Immune Deficiency Syndrome (AIDS)

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Balanoposthitis

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Calymmatobacterium Granulomatis

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Chancroid

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Chlamydia Trachomatis

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Genital Herpes

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Genital Warts

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Gonorrhea

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Granuloma Inquinale

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Haemophilus Ducreyi

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HIV Infection

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Lymphogranuloma Venereum