A screening tool developed by medical providers is an effective way to spot signs of child abuse, and experts are raising awareness about it today.

The TEN-4 rule stands for "Torso, Ears and Neck," an easy-to-remember prompt to examine high-risk bruising on young children that should be considered as a red flag for abuse.

Tamara Brown, director of the Health Access Nurturing Development Services (HANDS) program at Family and Children's Place Jefferson County, said the home visitation program that provides resources for new or expectant parents includes education on the TEN-4 rule to help people spot any potential signs of abuse of their child or neighbors' and friends' children.

"We work with children under the age of two and prenatal families," she said, "and what we are hoping is that we can really provide a lot of support for those most vulnerable populations. Children under two are the highest-risk group for death through child abuse."

Kentucky's rate of child abuse decreased in 2022, but the number of reported abuse and neglect cases in the state still surpasses the national average, according to federal data. Around a dozen Kentucky kids out of every 1,000 experienced some form of maltreatment during 2022.

For more information on the rule, visit faceitabuse.org/ten4rule.

Dr. Melissa Currie, professor and endowed chair for pediatric forensic medicine at the University of Louisville School of Medicine, explained that bruising - particularly on babies - isn't normal. It can be a sign of something serious: If not abuse, then a bleeding disorder or even cancer.

"It does not necessarily mean that it's abuse," Currie noted. "That said, the rule helps us determine high-risk bruising with enough specificity that if a child screens positive, they definitely need medical workup, and they need it right away."

Barry Dunn, president and CEO of Kosair for Kids, the group that created the TEN-4 Day observance, said all Kentuckians have a role to play in preventing child abuse and neglect.

"We are proud of the progress that we've made. That drop is big," he said. "We've gone from worst in the nation to 14th worst. We're not going to plant a flag with that advancement, but it is a data point."

If you suspect a child is being abused or neglected, contact the statewide Child Abuse Hotline at 877-597-2331 to make a report.

CORRECTION: The number of reports to Virginia Child Protective Services that are found to include abuse or neglect is just under 3,000. An earlier version of this story said 'more than 1,000.' (4:17 p.m. MDT, Dec. 30, 2024) )

Virginia's child welfare system grapples with a surge of unfounded reports that critics say stem from overly broad mandatory reporting laws, disrupting families and straining resources.

Just under 3,000 of more than 90,000 annual reports to Child Protective Services are 'founded,' meaning abuse or neglect was determined to have occurred after an investigation, said Valerie L'Herrou, deputy director of the Virginia Poverty Law Center's Center for Family Advocacy.

L'Herrou explained that some parents are forced into impossible choices because of poverty, and can face neglect accusations even though their actions stem from economic necessity, not intentional disregard for their children's well-being.

"And that's when the nosy neighbor picks up the phone and calls CPS," she said, "and so these are the kinds of things: a family's water gets turned off because they can't afford to pay their water bill and so kids show up to school unbathed, and the teacher calls CPS."

L'Herrou said agencies such as the Virginia Department of Social Services are now classifying some situations as "Poverty Adjacent Neglect," acknowledging that families often lack the resources they need. She advocated for solutions that address these root causes, including raising the minimum wage, strengthening programs such as SNAP and TANF, and expanding access to affordable child care.

Mandatory reporting laws have also created a dilemma for teachers, doctors and other professionals. Anna Daniszewski, a staff attorney for family defense at the VPLC, emphasized that people often fail to recognize the enduring and traumatic consequences of a false report to Child Protective Services.

"There's still harm in a call that leads to an assessment or inquiry or investigation that turns out to be unfounded," she said. "Depending on if the report is about a bruise on an arm, a child might be strip-searched, and that's obviously traumatic, or even just the experience of having CPS knock on your door."

Advocates have said one solution would be using family resource centers to allow parents to ask for help without the fear of involving CPS. They also want better training for mandatory reporters.

Teachers are the top reporters of neglect and abuse, and groups such as the American Federation of Teachers now support an approach known as "mandated support," giving them a broader range of options beyond mandatory reporting.

A Missouri-based therapy dog has an inspiring journey that began as a homeless stray on the streets of Los Angeles.

Olive, a ten-pound poodle mix, is now the lead character in a new children's book titled, "Olive, She's All Love." She was rescued by Brandon McMillan, host of CBS's "Lucky Dog," where she received specialized training and became a certified therapy dog.

Lisa Groves-Bax, a children's advocate and owner of Therapy Paws, became Olive's owner in 2016, where the dog has been used to comfort Missouri children in the court system and inspired Groves-Bax to share her story. She said their mission to support kids who are hurting extends beyond the courtroom.

"There's schools, there's foster homes, there's libraries, all these places who are wanting a therapy dog just to help with kiddos," Groves-Bax outlined. "We have 23 certified handlers along with their certified therapy dogs, and three currently in training."

Olive is scheduled to visit Glasgow's Lewis Library and grade school Jan. 8 for an event for kindergartners through grade five.

Deborah Zemke, illustrator of the book, will also be there to share more about Olive's work. She said working on this book brought about a unique experience in her career.

"I've done a lot of books. This is the first time that I've, like, met my hero character in person before I started," Zemke recounted. "That was kind of unusual and kind of fun."

"Olive, She's all Love" can be found online and at local bookstores.


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Child tax credits offer a financial lifeline to parents and can lift children out of poverty, according to a report from New Mexico's Voices for Children.

Jacob Vigil, deputy policy director for the nonprofit, noted in addition to federal child tax credits, New Mexico is one of 16 states with its own child tax credit. He said the credits, including refundable credits, are among the most effective ways to fight poverty because they return money directly to families who know best how to address their specific needs.

"These tax credits play a really important non-stigmatizing role in providing assistance to families in most need of support," Vigil explained.

In New Mexico, Vigil pointed out the state returned $132 million to almost 240,000 households this year through the state's child tax credit program. The credit varies by income level, with the largest credits available to low-income families. Because it is refundable, families can receive the full amount for which they are eligible regardless of their tax liability.

Studies show generous tax credits can lead to long-term improvements in health and higher earnings in adulthood, and also improve school performance, which increases college attendance rates. According to Vigil, extra federal child tax credits provided to families during the pandemic had a huge effect on the state's children.

"With the expansion of the federal CTC and it being refundable temporarily in 2021, that was 450,000 kids -- and that's 95% of the child population -- 32,000 children lifted out of poverty," Vigil reported.

Post pandemic, the federal child tax credit is no longer fully refundable, which means 36% of New Mexico families earning the lowest incomes are unable to access the full federal credit, while at the same time, a married couple making up to $400,000 receives the full amount of the tax credit.