4.1 Key Components of Child Abuse (23 Pa.C.S. § 6303)

• Child:  An individual under 18 years of age
• Recent act; Act or failure to act; Recent act or failure to act; Series of Acts or Failures to act
  • Act:  Something that is done to harm or cause potential harm to a child
  • Failure to act:  Something that is NOT done to prevent harm or potential harm to a child
  • Recent act:  Any act committed within two years of the date of the report to DHS or county agency
  • Recent act or failure to act:  Any act or failure to act committed within two (2) years of the date of the report to DHS or county agency
• Intentionally, Knowingly, or Recklessly
  • Intentionally: Done with the direct purpose of causing the type of harm that resulted
  • Knowingly: Awareness that harm is practically certain to result
  • Recklessly: Conscious disregard of substantial and unjustifiable risk

4.2 Perpetrator (23 Pa.C.S. § 6303)

A perpetrator is an individual who has committed child abuse as defined under section 6303(b.1) of the PA CPSL (relating to definitions). The term includes only the following:

• A parent of the child
• A spouse or former spouse of the child’s parent
• A paramour or former paramour of the child’s parent
• A person 14 years of age or older who is responsible for the child’s welfare or has direct contact with children as an employee of childcare services, a school, or through a program, activity, or service
• An individual 14 years of age or older who resides in the same home as the child
• An individual 18 years of age or older who does not reside in the same home as the child but is related within the third degree of consanguinity or affinity by birth or adoption to the child
• An individual 18 years of age or older who engages a child in severe forms of trafficking in persons or sex trafficking, as those terms are defined under section 103 of the Trafficking Victims Protection Act of 2000 (114 Stat. 1466, 22 U.S.C. § 7102).

Note:  Nothing in the PA CPSL requires a person who has reasonable cause to suspect a child is a victim of child abuse to identify the person responsible for the child abuse in order to make a report of suspected child abuse.

Only the following may be considered a perpetrator for failing to act:

• A parent of the child
• A spouse or former spouse of the child’s parent
• A paramour or former paramour of the child’s parent
• A person 18 years of age or older who is responsible for the child’s welfare
• A person 18 years of age or older who resides in the same home as the child

4.3 Categories & Indicators of Child Abuse (23 Pa.C.S. § 6303)

An indicator is an alert or warning that more attention must be given to a situation. Indicators of abuse can be obvious: for example, a child with the mark of a belt showing on his or her back or burns in the shape of an iron or cigarette tip gives clear support for reasonable cause to suspect child abuse. Often suspicion may rest on less obvious physical or behavioral indicators.

4.3.1 Child Abuse

Child abuse: Intentionally, knowingly, or recklessly doing any of the following:

1. Causing bodily injury to a child through any recent act or failure to act.
2. Fabricating, feigning, or intentionally exaggerating or inducing a medical symptom or disease which results in a potentially harmful medical evaluation or treatment to the child through any recent act.
3. Causing or substantially contributing to serious mental injury to a child through any act or failure to act or a series of such acts or failures to act.
4. Causing sexual abuse or exploitation of a child through any act or failure to act.
5. Creating a reasonable likelihood of bodily injury to a child through any recent act or failure to act.
6. Creating a likelihood of sexual abuse or exploitation of a child through any recent act or failure to act.
7. Causing serious physical neglect of a child.
8. Causing the death of the child through any act or failure to act.
9. Engaging a child in a severe form of trafficking in persons or sex trafficking, as those terms are defined under section 103 of the Trafficking Victims Protection Act of 2000.
10. Engaging in any of the following recent “per se” acts:
    1. Kicking, biting, throwing, burning, stabbing, or cutting a child in a manner that endangers the child
    2. Unreasonably restraining or confining a child based on consideration of the method, location, or the duration of the restraint or confinement
    3. Forcefully shaking a child under one year of age
    4. Forcefully slapping or otherwise striking a child under one year of age
    5. Interfering with the breathing of a child
    6. Causing a child to be present at a location while a violation of 18 Pa.C.S.§7508.2 (relating to operation of methamphetamine laboratory) is occurring, provided the violation is being investigated by law enforcement
    7. Leaving a child unsupervised with an individual, other than the child’s parent, who the actor knows or reasonably should have known:
       1. Is required to register as a Tier II or Tier III sexual offender under 42 Pa.C.S. Ch. 97 Subch. H (relating to registration of sexual offenders), where the victim of the sexual offense was under 18 years of age when the crime was committed
       2. Has been determined to be a sexually violent predator under 42 Pa.C.S.§9799.24 (relating to assessments) or any of its predecessors
       3. Has been determined to be a sexually violent delinquent child as defined in 42 Pa.C.S.§9799.12 (relating to definitions)
       4. Has been determined to be a sexually violent predator under 42 Pa.C.S.§9799.58 (relating to assessments) or has to register for life under 42 Pa.C.S.§9799.55(b) (relating to registration)

4.3.2 Bodily Injury

General rule—the following words and phrases, when used in the PA CPSL, shall have the meanings given to them in this section unless the context clearly indicates otherwise.

Bodily injury is the impairment of physical condition or substantial pain.

• Impairment: If, due to the injury, the child’s ability to function is reduced temporarily or permanently in any way
• Substantial pain:  If the child experiences what a reasonable person believes to be substantial pain

Indicators of bodily injury include unexplained injuries, unbelievable or inconsistent explanations of injuries or injuries that are inconsistent with a child’s age/developmental level. Indicators can include:

• Fear of going home
• Fear of parent or caregiver
• Extreme apprehensiveness/vigilance
• Pronounced aggression or passivity
• Flinches easily or avoids being touched
• Play includes abusive talk or behavior
• Unexplained injuries
• Unbelievable or inconsistent explanations of injuries
• Injuries inconsistent with a child’s age/developmental level
• Unable to recall how injuries occurred, or account of injuries is inconsistent with the nature of the injuries
• Multiple bruises in various stages of healing
• Bruises located on face, ears, neck, buttocks, back, chest, thighs, back of legs, and genitalia
• Bruises that resemble objects such as a hand, fist, belt buckle, or rope
• Burns

4.3.3 Serious Mental Injury

Emotional abuse and emotional neglect are among the most prevalent of childhood maltreatment types and associated with a range of poor mental health outcomes (Kumari, 2020). A large body of evidence has demonstrated that exposure to childhood maltreatment at any stage of development can have long-lasting consequences (Lippard and Nemeroff, 2020).

Serious mental injury is a psychological condition, as diagnosed by a physician or licensed psychologist, including the refusal of appropriate treatment, that (CWIG, 2022, May):

• Renders a child chronically and severely anxious, agitated, depressed, socially withdrawn, psychotic, or in reasonable fear that the child’s life or safety is threatened; or
• Seriously interferes with a child’s ability to accomplish age-appropriate developmental and social tasks.

Indicator of serious mental injury can include:

• Expressing feelings of inadequacy
• Fearful of trying new things
• Overly compliant
• Poor peer relationships
• Excessive dependence on adults
• Habit disorders (sucking, rocking, etc.)
• Eating disorders
• Frequent psychosomatic complaints (nausea, stomachache, headache, etc.)
• Bed-wetting
• Self-harm
• Speech disorders

4.3.4 Serious Physical Neglect

Physical neglect is an act of abuse. Neglect accounts for nearly 75% of confirmed cases of child maltreatment in the United States—far more than physical or sexual abuse (USDHHS, 2024).

Identifying serious physical neglect in children can be more difficult than identifying other forms of abuse because neglect usually involves the absence of a certain behavior, rather than the presence. A thorough investigation of the child’s safety and risk, followed by a comprehensive family assessment can help determine what kinds of services and supports the family may need.

Serious physical neglect is any of the following when committed by a perpetrator that endangers a child’s life or health, threatens a child's well-being, causes bodily injury, or impairs a child's health, development, or functioning:

• A repeated, prolonged or egregious failure to supervise a child in a manner that is appropriate considering the child’s developmental age and abilities.
• The failure to provide a child with adequate essentials of life, including food, shelter, or medical care.

Indicators of serious physical neglect can include:

• Not registered in school
• Inadequate or inappropriate supervision
• Poor impulse control
• Frequently fatigued
• Parentified behaviors
• Lack of adequate medical and dental care
• Often hungry
• Lack of shelter
• Weight is significantly lower than normal for age and gender
• Developmental delays
• Persistent (untreated) conditions (e.g., head lice, diaper rash)
• Exposure to hazards (e.g., illegal drugs, rodent/insect infestation, mold)
• Clothing that is dirty, inappropriate for the weather, too small, or too large

4.3.5 Sexual Abuse or Exploitation

According to National Children’s Alliance data collected by forensic interviews conducted at accredited Child Advocacy Centers in 2020, over 91% of alleged offenders that children disclosed abuse from, were individuals that those children already knew. Those offenders included parents, stepparents, other relatives such as uncles, caregivers’ significant others, and other known people in their lives (First Witness Child Advocacy Center, 2024).

Victims are often threatened with negative consequences to keep them silent. Certain factors contribute to their silence, including secrecy, helplessness, entrapment, accommodation, and the fear of not being taken seriously when revealing abuse.

Sexual abuse or exploitation is the employment, use, persuasion, inducement, enticement, or coercion of a child to engage in or assist another individual to engage in sexually explicit conduct, which includes, but is not limited to, the following:

• Looking at the sexual or other intimate parts of a child or another individual for the purpose of arousing or gratifying sexual desire in any individual
• Participating in sexually explicit conversation either in person, by telephone, by computer, or by a computer-aided device for the purpose of sexual stimulation or gratification of any individual
• Actual or simulated sexual activity or nudity for the purpose of sexual stimulation or gratification of any individual
• Actual or simulated sexual activity for the purpose of producing visual depiction, including photographing, videotaping, computer depicting, or filming

This does not include consensual activities between a child who is 14 years of age or older and another person who is 14 years of age or older and whose age is within four years of the child's age.

Sexual abuse or exploitation also includes any of the following when committed against a child:

• Rape as defined in 18 Pa.C.S.§3121
• Statutory sexual assault as defined in 18 Pa.C.S.§3122.1
• Involuntary deviate sexual intercourse as defined in 18 Pa.C.S.§3123
• Sexual assault as defined in 18 Pa.C.S.§3124.1
• Institutional sexual assault as defined in 18 Pa.C.S.§3124.2
• Aggravated indecent assault as defined in 18 Pa.C.S.§3125
• Indecent assault as defined in 18 Pa.C.S.§3126
• Indecent exposure as defined in 18 Pa.C.S.§3127
• Incest as defined in 18 Pa.C.S.§4302
• Prostitution as defined in 18 Pa.C.S.§5902
• Sexual abuse as defined in 18 Pa.C.S.§6312
• Unlawful contact with a minor as defined in 18 Pa.C.S.§6318
• Sexual exploitation of children as defined in 18 Pa.C.S.§6320

Indicators of sexual abuse or exploitation can include:

• Sexually promiscuous behaviors
• Cruelty to others
• Cruelty to animals
• Fire setting
• Anxious
• Withdrawn
• Sleep disturbances
• Bedwetting
• Pain or irritation in genital/anal area
• Difficulty walking or sitting
• Difficultly urinating
• Excessive or injurious masturbation
• Pregnancy
• Positive testing for sexually transmitted disease(s) (e.g., HIV)
• Developmental age-inappropriate sexual play and/or drawings

4.3.6 Severe Forms of Trafficking in Persons (Act 115 of 2016)

The scale of human trafficking is atrocious. The silence that conceals this crime is disgraceful. We have to speak out because the victims are living in fear for their lives. We have to raise our voices for them. That means confronting the social and economic conditions that abet this crime. It means arresting the traffickers. And above all, it means protecting the victims.

– Former United Nations Secretary General Ban Ki-moon

In an effort to integrate human trafficking elements into Pennsylvania’s child abuse law, the General Assembly now recognizes human trafficking as a form of child abuse and neglect. Act 115 of 2016 added “engaging a child in a severe form of trafficking in persons or sex trafficking” as part of the definition of child abuse. This includes both sex trafficking and labor trafficking of children.

Act 115 of 2016:

• Adds a category of child abuse to include:
  • Engaging a child in a severe form of trafficking in persons or sex trafficking, as those terms are defined under section 103 of the Trafficking Victims Protection Act of 2000.
• Adds a category of perpetrator to include:
  • an individual 18 years of age or older who engages a child in severe forms of trafficking in persons or sex trafficking, as those terms are defined under section 103 of the Trafficking Victims Protection Act of 2000.
• Provides for additional grounds for involuntary termination of parental rights.
• Provides for additional grounds for aggravated circumstances.
• Allows for release of information in confidential reports to law enforcement when investigating cases of severe forms of trafficking in persons of sex trafficking.

Severe forms of trafficking in persons includes sex trafficking in which a commercial sex act is induced by force, fraud, or coercion or in which the person induced to perform such act has not attained 18 years of age; or

• Sex trafficking: the recruitment, harboring, transportation, provision, obtaining, patronizing, or soliciting of a person for the purpose of a commercial sex act
• Commercial sex act: Any sex act on account of which anything of value is given to or received by any person

It also includes the recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through the use of force, fraud, or coercion, for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery.

• Peonage: paying off debt through work
• Debt Bondage: debt slavery, bonded labor, or services for a debt or other obligation
• Slavery: A condition compared to that of a slave in respect of exhausting labor or restricted freedom

Labor trafficking: Labor obtained by use of threat of serious harm, physical restraint, or abuse of legal process. Examples include:

• Being forced to work for little or no pay (frequently in factories and farms)
• Domestic servitude: providing services within a household for 10-16 hours per day, such as, but not limited to: childcare, cooking, cleaning, yard work, gardening, etc.

Severe forms of human trafficking should be suspected when a person verified to be under the age of 18 is in any way involved in a commercial sex act industry or has a record of prior arrest for prostitution or related charges. A victim may be hypervigilant or paranoid, avoids answering question (or let someone else speak for them), or lie about or have no identification or knowledge of personal data, such as but not limited to age, name, and/or date of birth.

Other warning signs can include:

• Maintains an explicitly sexual online profile, increased social media, new associates or friends at school.
• Frequents internet chat rooms and classified sites.
• Depicts elements of sexual exploitation in drawing, poetry, or other modes of creative expression.
• Has tattoos they’re reluctant to explain.
• Has late nights, unusual hours, or secrecy about their whereabouts.
• Is found in a hotel, street track, truck stop, or strip club.
• Does not have insurance or control over own finances.
• Wears clothing that is dirty and inappropriate for the weather; it may be too large or too small (often dresses or skirts that are provocative in nature).
• Wears new clothes of any style and gets hair and/or nails done with no financial means.
• Has multiple cell phones or very expensive items that they have no way of purchasing on their own.
• Uses specific terms such as “trick”, “the life”, or “the game”.
• Involved in controlling or dominating relationships.
• Has interest in or is in relationships with adults or older adults.

Medical warning signs can include:

• Unaddressed medical issues, coming to the ER or clinic alone or with an unrelated adult.
• Significant changes in behavior, including increased social media and new associates or friends at school.
• Frequent or multiple sexually transmitted diseases or pregnancies.
• Unexplained injuries and/or unbelievable or inconsistent explanations of injuries.
• Multiple bruises or cuts in various stages of healing.

At-risk youth populations can include youth:

• In the foster care system
• Who identify as LGBTQ+
• Who are homeless or a runaway
• With disabilities
• With a history of sexual abuse
• With mental health and/or substance abuse disorders
• With a history of being involved in the welfare system
• Who identify as native or aboriginal
• With family dysfunction

4.4 Exclusions from Child Abuse (23 Pa.C.S.§6304)

Conduct that causes injury or harm to a child or creates a risk of injury or harm to a child shall not be considered child abuse if there is no evidence that the person acted intentionally, knowingly or recklessly when causing the injury or harm to the child or creating a risk of injury or harm to the child.

The term “child abuse” does not include any conduct for which an exclusion is provided in section 6304 of the PA CPSL (relating to exclusions from child abuse).

Note: Nothing in the PA CPSL requires a person who has reasonable cause to suspect a child is a victim of child abuse to consider the exclusions from child abuse before making a report of suspected child abuse.

The exclusions from child abuse are considered/determined by DHS or the investigating agency after receipt of a referral/report.

4.4.1 Environmental Factors

No child shall be deemed to be physically or mentally abused based on injuries that result solely from environmental factors—such as inadequate housing, furnishings, income, clothing, and medical care—that are beyond the control of the parent or person responsible for the child’s welfare with whom the child resides. This exclusion shall not apply to any childcare service as defined in the PA CPSL, excluding an adoptive parent.

4.4.2 Practice of Religious Beliefs

If, upon investigation, the county agency determines that a child has not been provided needed medical or surgical care because of sincerely held religious beliefs of the child's parents or relative within the third degree of consanguinity and with whom the child resides—which beliefs are consistent with those of a bona fide religion—the child shall not be deemed to be physically or mentally abused. In such cases, the following shall apply:

1. The county agency shall closely monitor the child and the child’s family and shall seek court-ordered medical intervention when the lack of medical or surgical care threatens the child’s life or long-term health.
2. All correspondence with a subject of the report and the records of DHS and the county agency shall not reference child abuse and shall acknowledge the religious basis for the child’s condition.
3. The family shall be referred for general protective services, if appropriate.
4. This exclusion shall not apply if the failure to provide needed medical or surgical care causes the death of the child.
5. This exclusion shall not apply to any childcare service as defined under section 6303(a) of the PA CPSL (relating to definitions), excluding an adoptive parent.

4.4.3 Use of Force for Supervision, Control, and Safety Purposes

The use of reasonable force (relating to rights of parents) on or against a child by the child’s own parent or person responsible for the child’s welfare shall not be considered child abuse if any of the following conditions apply:

1. The use of reasonable force constitutes incidental, minor, or reasonable physical contact with the child or other actions that are designed to maintain order and control.
2. The use of reasonable force is necessary:
   1. to quell a disturbance or remove the child from the scene of a disturbance that threatens physical injury to persons or damage to property;
   2. to prevent the child from self-inflicted physical harm;
   3. for self-defense or the defense of another individual; or
   4. to obtain possession of weapons or other dangerous objects or controlled substances or paraphernalia that are on the child or within the control of the child.

4.4.4 Rights of Parents

Nothing in the PA CPSL shall be construed to restrict the generally recognized existing rights of parents to use reasonable force on or against their children for the purposes of supervision, control, and discipline of their children. Such reasonable force shall not constitute child abuse.

4.4.5 Participation in Events That Involve Physical Contact with Child

An individual participating in a practice or competition in an interscholastic sport, physical education, a recreational activity, or an extracurricular activity that involves physical contact with a child does not, in itself, constitute contact that is subject to the reporting requirements of the PA CPSL.

4.4.6 Child-on-Child Contact

1. Harm or injury to a child that results from the act of another child shall not constitute child abuse unless the child who caused the harm or injury is a perpetrator.
2. Notwithstanding paragraph (1) above, the following shall apply:
   1. Acts constituting any of the following crimes against a child shall be subject to the reporting requirements of the PA CPSL:
      1. Rape as defined in 18 Pa.C.S.§3121
      2. Involuntary deviate sexual intercourse as defined in 18 Pa.C.S. §3123
      3. Sexual assault as defined in 18 Pa.C.S.§3124.1
      4. Aggravated indecent assault as defined in 18 Pa.C.S.§3125
      5. Indecent assault as defined in 18 Pa.C.S.§3126
      6. Indecent exposure as defined in 18 Pa.C.S.§3127
3. Notwithstanding paragraph (1) above, the following shall apply:
   1. No child shall be deemed to be a perpetrator of child abuse based solely on physical or mental injuries caused to another child in the course of a dispute, fight, or scuffle entered into by mutual consent.
   2. A law enforcement official who receives a report of suspected child abuse is not required to make a report to DHS if the person allegedly responsible for the child abuse is a non-perpetrator child.

4.4.7 Defensive Force

Reasonable force for self-defense or the defense of another individual consistent with the provisions of 18 Pa.C.S.§§505 (relating to use of force in self-protection) and 506 (relating to use of force for the protection of other persons) shall not be considered child abuse.