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.

The lack of quality child care for infants and toddlers costs Colorado nearly $3 billion each year in lost earnings, productivity and revenue but an initiative in Mesa County shows what is possible when local governments, businesses and civic groups team up.

Keller Anne Ruble, client success manager for the data firm BridgeCare, said officials saw huge demand for child care in the town of Clifton, but no providers. So they built a new facility that provides child care and also trains new caregivers.

"So that they can meet the needs of working families and invest in their early care workforce pipeline," Ruble explained. "And because of that investment, they now have 270 seats at this child care center, and they've completely eliminated their child care desert."

Budgetary constraints imposed by Colorado's Taxpayer Bill of Rights make it much harder for the state to invest tax revenues in initiatives such as the one in Clifton. The state also recently froze enrollment in the Colorado Child Care Assistance Program. Over the past 15 years, Colorado's economic growth has dropped from fifth in the nation to 41st, according to the 2025 Colorado University Leeds School of Business report.

Half of Colorado parents said they have quit jobs, worked fewer hours and taken unpaid time off. In 2023, more than 10,000 moms left the workforce, all because of a lack of child care.

Ruble emphasized when the cost of child care is too high, many parents just cannot afford to go to work.

"Families across the country are spending up to 60% of their income on child care," Ruble pointed out. "That's equivalent to a second mortgage or a second rent payment."

Children younger than age 3 are experiencing one of the most crucial periods of brain development and Ruble stressed investing in quality care is important for their long-term health.

"When young children have high-quality, enriching early experiences with trusted caregivers, it sets them on a strong foundation for growing, flourishing into thriving adults that contribute to our workforce and our society," Ruble asserted.


get more stories like this via email

The number of Kentucky children enrolled in preschool increased in 2024, along with state spending per child, according to new data from the National Institute for Early Education Research.

The commonwealth spent around $6,500 per child during the last academic year, an increase of more than $800 from the prior year.

Steve Barnett, founder and senior director of the institute and the study's co-author, said it is unrealistic to think states could replace cuts to Head Start funding amid the Trump administration's proposed freezes of federal grant funding.

"And particularly replace it overnight if the program is suddenly defunded," Barnett emphasized. "States are going to have to step up and figure out what to do if that happens."

He added if Head Start funding is eliminated, access to public preschool will decline in several states by more than 10 percentage points, and in some, by 20.

Kentucky lawmakers have taken recent steps to expand preschool access, including passing House Bill 695, which established the Adaptive Kindergarten Readiness Pilot Project. The measure aims to provide no-cost, online education for 3- and 4-year-olds who may not be attending state-funded preschool programs.

Allison Friedman-Krauss, associate research professor at the institute, said states spent more than $13 billion on preschool last year, including $257 million in federal pandemic relief funding, in part to attract more qualified teachers.

"We also see in our data that many states are reporting teacher shortages in early childhood, that they've had to increase their waivers in order to get teachers in classrooms," Friedman-Krauss reported.

Research shows toddlers who attend preschool are more prepared for elementary school and less likely to be identified as having special needs, or be held back, than children who do not.


get more stories like this via email

Medicaid is in the crosshairs, as Republicans in Congress are expected to lay out proposals in May to cut $1.5 trillion from the federal budget, prompting strong opposition from educators.

Around 15 million Californians rely on Medicaid, known here as Medi-Cal, for their health care. However, as Mayra Alvarez, president of the Children's Partnership, noted, the cuts would also deal a devastating blow to schools.

"Medicaid is the third-largest source of funding for K-through-12 public schools to help children have access to routine health screenings, preventive services and physical speech and occupational therapies," she said.

The Trump administration is looking for savings to fund the president's other priorities, including extending his 2017 tax cuts, which primarily benefit the wealthy and corporations. School districts are uneasy because they are legally required to provide accommodations for students with disabilities, regardless of how much the federal government is willing to reimburse.

Sacramento County schools superintendent David Gordon said districts would have to make big cuts across all programs.

"Without those funds, there would be a huge bill," he said, "and school districts would be forced to basically play financial roulette to figure out what do we cut?"

Gordon said his district uses Medi-Cal funds to place mental-health clinicians at each school site, so students with psychological needs get early diagnosis and treatment.

Shana Hazan, a trustee for the San Diego Unified School District, said people don't realize the critical role districts play in providing health-care services.

"Students rely on Medi Cal for things like audiology, mental-health support, nursing and wellness, occupational and physical therapy, home hospital care," she said. "These are really essential for many students with the highest needs."